Shelby Chimiak, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP023988 Issued in PA

Practice address

3 Farm Colony Dr
Warren, PA 16365-5209

Phone

(866) 682-3250

NPI assigned

Jun 11, 2021

Last updated

Aug 25, 2021By 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1194393611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27337 BECKMAN RD",
            "city": "CAMBRIDGE SPRINGS",
            "state": "PA",
            "postal_code": "164034107",
            "telephone_number": "724-815-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FARM COLONY DR",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163655209",
            "telephone_number": "866-682-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMIAK",
        "first_name": "SHELBY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "F04210481",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF NURSING",
            "identifier": "RN661177",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF NURSING",
            "identifier": "SP023988",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Marie Cerra, M.S. CCC-SLP
• Charcoal and Grey Inc. (Charcoal and Grey)
• Children's Center for Treatment and Education (Beacon Light Behavioral Health Systems)
• Children's Center for Treatment and Education (Beacon Light Behavioral Health System)
• Children's Center for Treatment and Education (Beacon Light Behavioral Health System)
• Megan Sue Church, DO
• City of Warren
• Nicole Marie Clark, M.S. R.D.
• Edwina Clarke, MD
• Beverly Ann Clever, COTA

• Family Nurse Practitioner in Warren, PA
• Providers in Warren, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.