Shelly Ray Brockman, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012051 Issued in KY

Practice address

100 Clint Hill Blvd
Paducah, KY 42001-6771

Phone

(270) 441-4357

NPI assigned

Mar 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Ky Urgent Care LLCGroup PAC ID 2860832763, 9 clinicians

Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sballiet187876@direct.bsmhealth.org

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.

• Mercy Health Ky Urgent Care LLC

  • Urgent Care Clinic/Center
  • Paducah, KY
  • NPI 1861104374
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093
  Medicare reassignment Care Compare group

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

• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Hospital

  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  Care Compare affiliation

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1184126260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CLINT HILL BLVD STE 100",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CLINT HILL BLVD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016771",
            "telephone_number": "270-441-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1532 Lone Oak Rd Ste 345",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420037942",
            "country_code": "US",
            "telephone_number": "270-444-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "SHELLY",
        "middle_name": "RAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadway Church of Christ
• Broadway Dental Care
• Broadway Dental Care, PLLC
• Nathan Brockett
• Blair Brockman, APRN
• Ashlee Brockwell, LPP
• Bryar Jeannine Brooks, DMD
• Hannah Kathryn Brooks, LCSW
• Renda L Brooks
• Brown Physical Therapy Services

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.