Shelley Nicole Gough, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010755A Issued in IN

Practice address

2200 Forest Ridge Pkwy Ste 310
New Castle, IN 47362-2943

Phone

(765) 599-3400

NPI assigned

Dec 30, 2020

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shelley Nicole Copeland Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry County Memorial HospitalGroup PAC ID 6002724085, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCMH Home Care Home health agency, New Castle, IN, CCN 157430
• Henry County Memorial Hospital Hospital, New Castle, IN, CCN 150030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry County Memorial Hospital

  dba Healthlink

  • Family Medicine Physician
  • New Castle, IN
  • NPI 1891570537
  Medicare reassignment Care Compare group NPD
• FC Indiana, LLC

  dba First Care Clinics

  • Nurse Practitioner
  • Bedford, IN
  • NPI 1225579063
  Medicare reassignment NPD
• FC Indiana, LLC

  • Rural Health Clinic/Center
  • Bedford, IN
  • NPI 1841911591
  NPD
• Henry County Memorial Hospital

  dba Integrative Well-Being

  • Primary Care Clinic/Center
  • New Castle, IN
  • NPI 1851780415
  NPD
• Henry County Memorial Hospital

  dba Fairway Village

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1952452815
  NPD
• Heritage House of Richmond

  • Skilled Nursing Facility
  • Richmond, IN
  • NPI 1467590562
  NPD (past)

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

• Henry County Memorial Hospital

  • General Acute Care Hospital
  • New Castle, IN
  • NPI 1356428429
  Care Compare affiliation
• Henry County Memorial Hospital

  dba HCMH Home Care

  • Home Health Agency
  • New Castle, IN
  • NPI 1568535748
  Care Compare affiliation

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1164019501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473620485",
            "telephone_number": "765-521-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FOREST RIDGE PKWY STE 310",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473622943",
            "telephone_number": "765-599-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Wittenbraker Ave",
            "address_purpose": "LOCATION",
            "city": "New Castle",
            "state": "IN",
            "postal_code": "473625000",
            "country_code": "US",
            "telephone_number": "765-599-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3512 Stellhorn Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468154631",
            "country_code": "US",
            "telephone_number": "260-483-9081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "SHELLEY",
        "middle_name": "NICOLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010755A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28194797A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "COPELAND",
            "middle_name": "NICOLE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Jayne Garza, PHARMD
• Emily Gerard
• Toni L Gesler, PHD
• Candra Sue Gigliotti, NP
• Tobey Lyn Gilmore, FNP-C
• Robert E Gould, M.D.
• Erin Grasse, COTA
• Kenzi Greenwood, RPH
• Brandi Grider
• Joseph A Grider IV, D.D.S

• Family Nurse Practitioner in New Castle, IN
• Providers in New Castle, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.
• 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.