Shelis R Jorgensen, ADVANCED NURSE PRACT

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NURU798 Issued in AK

Practice address

209 W Evergreen Ave Ste a
Palmer, AK 99645-6952

Phone

(907) 861-1450

Fax

(907) 861-1460

NPI assigned

Mar 20, 2006

Last updated

Oct 17, 2023By 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 identifiers 1

Other names 1

• Shelis R Harrington Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Mat-Su Valley III LLCGroup PAC ID 5496941502, 26 clinicians

Mat Su Valley Medical Center LLCGroup PAC ID 5698686475, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ancora Home Health & Hospice Home health agency, Wasilla, AK, CCN 027008
• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Merit-based Incentive Payment System (MIPS)

Final score

88.18 of 100Reported as apm

Quality

71.02

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

88.18 of 100Reported as apm

Quality

71.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelis.jorgensen.1@2839.direct.athenahealth.com
• Direct secure messaging: shelis.jorgensen.2@2839.direct.athenahealth.com
• Direct secure messaging: shelis.jorgensen.3@2839.direct.athenahealth.com
• Direct secure messaging: shelis.jorgensen.p1@direct.crossroadmc.nextgenshare.com

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.

• Mat Su Valley Medical Center LLC

  dba Mat-Su Regional Urgent Care

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1912950148
  Medicare reassignment Care Compare group NPD
• Mat-Su Valley III LLC

  • Internal Medicine Physician
  • Palmer, AK
  • NPI 1366752560

  Family

  Medicare reassignment Care Compare group NPD
• Mat-Su Valley III LLC

  dba Mat Su Urgent Care - Palmer

  • Urgent Care Clinic/Center
  • Palmer, AK
  • NPI 1518472984
  NPD
• Mat-Su Valley Medical Center LLC

  dba Mat-Su Regional Medical Center

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  NPD

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

• Ancora Home Health & Hospice, LLC

  • Home Health Agency
  • Wasilla, AK
  • NPI 1801380043
  Care Compare affiliation
• Mat-Su Valley Medical Center LLC

  dba Mat-Su Regional Medical Center

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1164481107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W EVERGREEN AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456952",
            "telephone_number": "907-861-1450",
            "fax_number": "907-861-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W EVERGREEN AVE STE A",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456952",
            "telephone_number": "907-861-1450",
            "fax_number": "907-861-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34300 S Talkeetna Spur Rd",
            "address_purpose": "LOCATION",
            "city": "Talkeetna",
            "state": "AK",
            "postal_code": "996769701",
            "country_code": "US",
            "telephone_number": "907-733-2273",
            "fax_number": "907-733-1735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "SHELIS",
        "middle_name": "R",
        "credential": "ADVANCED NURSE PRACT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "NURU798",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": "CM3761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022309",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelis.jorgensen.1@2839.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "209 W Evergreen Ave Ste A",
            "city": "Palmer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996456952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELIS",
            "last_name": "HARRINGTON",
            "middle_name": "R",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jolly Care Assisted Living Home LLC
• Pahleah Jones
• Virginia Rebecca Jones
• Jacob Nathaniel Jordan, PHARMD
• Mary Ann Jorgensen, RDN
• Tyler Jorgensen, D.C., B.S.
• Josh Miller Counseling, LLC
• Miranda Jurik
• Cassandra Angela Justice, RN
• Annette Kasprzak, M.D

• Family Nurse Practitioner in Palmer, AK
• Providers in Palmer, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.