County Line Health Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COUNTY LINE HEALTH CLINIC

Practice address

36053 US Highway 287
Wiley, CO 81092-9702

Phone

(719) 688-9962

NPI assigned

Aug 30, 2021

Organization subpart

No

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

Authorized official

Name

Shelby Casper, MSN-FNPNPI 1821563016

Title

Owner

Phone

(719) 688-9962

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24285/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelby Malin Casper, FNP-C

  • Family Nurse Practitioner
  • Lamar, CO
  • NPI 1821563016
  Medicare reassignment NPD Authorized official
• Rachel R Buck, FNP-C

  • Family Nurse Practitioner
  • Wiley, CO
  • NPI 1629451091
  Medicare reassignment NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1124795836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36053 US HIGHWAY 287",
            "city": "WILEY",
            "state": "CO",
            "postal_code": "810929702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36053 US HIGHWAY 287",
            "city": "WILEY",
            "state": "CO",
            "postal_code": "810929702",
            "telephone_number": "719-688-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY LINE HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "CASPER",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-688-9962",
        "authorized_official_credential": "MSN-FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel R Buck, FNP-C
• County of Kiowa Hospital District
• High Plains Community Health Center Incorporated
• Kiowa County Hospital District
• Seondra Paintin, R.N.
• Rooted Within, Inc

• Family Nurse Practitioner in Wiley, CO
• Providers in Wiley, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.