Shelly Rae Shadrick, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

976 Issued in CO

Practice address

1760 E Ken Pratt Blvd Ste 401
Longmont, CO 80504-5311

Phone

(720) 718-8305

Fax

(720) 718-0955

NPI assigned

Nov 17, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
• Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
• Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
• Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
• Uchealth Broomfield Hospital Hospital, Broomfield, CO, CCN 060129

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Iowa Heart Center PC

  • Cardiovascular Disease Physician
  • West Des Moines, IA
  • NPI 1164410932
  NPD (past)

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

• Longs Peak Hospital

  • General Acute Care Hospital
  • Longmont, CO
  • NPI 1154876985
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1104262286
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1750392304
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780243055
  Care Compare affiliation
• Poudre Valley Health Care Inc

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1457494304

  Hospital

  Care Compare affiliation
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1679419808
  Care Compare affiliation
• Poudre Valley Health Care Inc

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1073172094
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374001
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1093374092
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1114586278
  Care Compare affiliation
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1184283103
  Care Compare affiliation

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1215919907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 E KEN PRATT BLVD STE 401",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045311",
            "telephone_number": "720-718-8305",
            "fax_number": "720-718-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E KEN PRATT BLVD STE 401",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045311",
            "telephone_number": "720-718-8305",
            "fax_number": "720-718-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADRICK",
        "first_name": "SHELLY",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "976",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001565",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001565",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "001565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04139551",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "POO986704",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Diane Settembre, M.D.
• Parker Seubert, DDS
• Roy Howard Sexton III, M.D.
• Jane Seymour, MSW
• SGM Medical Corporation
• Harvey Shaffer, DVM
• Marissa Shaffer, MA, LPC, R-DMT
• Grishma S Shah, MD
• Nirav R Shah, M.D
• Traci Shahan, WHNP-BC

• Physician Assistant in Longmont, CO
• Providers in Longmont, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.