Individual provider Active NPI

Shelby McMullen, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1134973159
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0037386 Issued in OH
Practice address
3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone
(614) 754-5500
Fax
(614) 754-5501
NPI assigned
Apr 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0037386 OH Primary
Registered Nurse 163W00000X RN.467486 OH

Addresses

Primary practice location

3400 Olentangy River Rd
Columbus, OH 43202-1523

Mailing address

3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone (614) 754-5500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ohio.gastro@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241031001599 OH Practitioner - Nurse Practitioner 0840723672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohio Gastroenterology Group, Inc.Group PAC ID 0143211284, 118 clinicians

Practice addresses (Care Compare)

3400 Olentangy River Rd
Columbus, OH 43202-1576
Phone (614) 754-5500

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.467486OHMDRegistered Nurse
APRN.CNP.0037386OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Gastroenterology Group, Inc. CurrentSince Oct 14, 2024 Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

L3977
Columbus, OH 43260

3400 Olentangy River Rd
Columbus, OH 43202
Phone (614) 754-5545

85 McNaughten Rd
Ste 320
Columbus, OH 43213
Phone 61475455005545

6670 Perimeter Dr
Ste 200
Dublin, OH 43016

722 Buckles Ct N
Ste 100
Gahanna, OH 43230
Phone (614) 754-5455

3000 Meadow Pond Ct
Ste 500
Grove City, OH 43123
Phone (614) 505-7511

1025 Refugee Rd
Ste 100A
Pickerington, OH 43147

430 Altair Pkwy
Ste 110
Westerville, OH 43082

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1134973159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "SHELBY",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0037386",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.467486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohio.gastro@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432021523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.