Individual provider Active NPI

Shelley B Caldwell

  • Family Nurse Practitioner
  • Connersville, IN
National Provider Identifier
1124981584
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71017480A Issued in IN
Practice address
3704 N Opportunity Dr
Connersville, IN 47331-1017
Phone
(765) 377-1300
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71017480A IN Primary

Addresses

Primary practice location

3704 N Opportunity Dr
Connersville, IN 47331-1017

Mailing address

3704 N Opportunity Dr
Connersville, IN 47331-1017
Phone (765) 377-1300

Other names 1

  • Shelley Ann Boucher Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251212000368 IN Practitioner - Nurse Practitioner 0143714592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

211 US Hwy 66 E
Tell City, IN 47586-2757
Phone (812) 772-4380

4152 W State Rd
Suite 56
Hanover, IN 47243-9070
Phone (901) 351-1791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71017480AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Nov 26, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 26, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 26, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 26, 2025 Accepting new patients

Locations

1159 W Jefferson St
Ste 204
Franklin, IN 46131

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1124981584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 N OPPORTUNITY DR",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311017",
            "telephone_number": "765-377-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 N OPPORTUNITY DR",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311017",
            "telephone_number": "765-377-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "SHELLEY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71017480A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "BOUCHER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.