Individual provider Active NPI

Shelby Burchett

  • Nurse Practitioner
  • Concord, NC
National Provider Identifier
1194692582
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
292413 Issued in NC
Practice address
205 Branchview Dr NE
Concord, NC 28025-3416
Phone
(704) 440-4689
Fax
(704) 956-2193
NPI assigned
Oct 20, 2025
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 292413 NC Primary

Addresses

Primary practice location

205 Branchview Dr NE
Concord, NC 28025-3416

Mailing address

205 Branchview Dr NE
Concord, NC 28025-3416
Phone (704) 440-4689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20260430004154 NC Practitioner - Nurse Practitioner 2567939135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Adio/Pennsylvania Institute of Straight Chiropractic, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

205 Branchview Dr NE
Concord, NC 28025-3416

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
292413NCMDNurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1194692582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BRANCHVIEW DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253416",
            "telephone_number": "704-440-4689",
            "fax_number": "704-956-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BRANCHVIEW DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253416",
            "telephone_number": "704-440-4689",
            "fax_number": "704-956-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHETT",
        "first_name": "SHELBY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "292413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.