Mindy Sue Shoulders, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71008958A Issued in IN

Practice address

4506 1St Ave
Evansville, IN 47710-3624

Phone

(812) 428-6161

Fax

(812) 421-2883

NPI assigned

Mar 27, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Nurse Practitioner

  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1013274471

  Nurse Practitioner

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1114488616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103624",
            "telephone_number": "812-428-6161",
            "fax_number": "812-421-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "MINDY",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008958A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Shivers
• Mark Edward Shockley, MD
• Sholar Center for Aesthetic Surgery
• April J Shoulders, NP
• Debra Kay Shoulders, ARNP
• Christopher C Shrack, DO
• Kadottie Miriam Shrader, LMHCA
• John Oslage Shrode, DDS
• Juhi Shukla, PT, MHS
• Lata R Shukla, MD

• Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.