Active NPI
Shelly Samuels, RN
- Psychiatric/Mental Health Registered Nurse
- Hobbs, NM
National Provider Identifier
1154770964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 75910
- Practice address
- 920 W Broadway St
Hobbs, NM 88240-5529 - Phone
- (575) 393-3168
- Fax
- (575) 397-4659
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 75910 | NE | Primary |
Addresses
Primary practice location
920 W Broadway St
Hobbs, NM 88240-5529
Mailing address
PO Box 907
Hobbs, NM 88241-0907
Phone (575) 393-3168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75910 | NE | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1154770964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 907",
"city": "HOBBS",
"state": "NM",
"postal_code": "882410907",
"telephone_number": "575-393-3168",
"fax_number": "575-397-4659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 W BROADWAY ST",
"city": "HOBBS",
"state": "NM",
"postal_code": "882405529",
"telephone_number": "575-393-3168",
"fax_number": "575-397-4659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "SHELLY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "NE",
"license": "75910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hobbs, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.