Individual provider Active NPI

Shelley Aldrich, M.D.

  • Dermatology Physician
  • Eglin Afb, FL
National Provider Identifier
1235355801
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01063778A Issued in IN
Practice address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone
(850) 883-8257
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01063778A IN Primary

Addresses

Primary practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Mailing address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone (850) 883-8257

Other practice location 1

4102 Pinion Dr
Usaf Academy, CO 80840-2502
Phone (719) 333-5291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009000039 FL Practitioner - Dermatology 1052842457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Skin Surgery and Dermatology, PLGroup PAC ID 3173715869, 15 clinicians

Practice addresses (Care Compare)

4400E Hwy 20 410
Niceville, FL 32578-9735
Phone (850) 897-4900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions116
Skin biopsy58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01063778AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Skin Surgery and Dermatology, PL Dermatology CurrentSince Nov 1, 2024 Accepting new patients
Gregory Winfield Turner Sr MD PA CurrentSince Nov 1, 2024 Accepting new patients

Locations

912 Mar Walt Dr
Fort Walton Beach, FL 32547
Phone (850) 314-7546

12469 US Highway 98 W
Ste 101
Miramar Beach, FL 32550
Phone (850) 654-3376

12469 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 650-7877

4400 E Highway 20
Ste 410
Niceville, FL 32578
Phone (850) 897-2000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1235355801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 Pinion Dr",
            "address_purpose": "LOCATION",
            "city": "Usaf Academy",
            "state": "CO",
            "postal_code": "808402502",
            "country_code": "US",
            "telephone_number": "719-333-5291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALDRICH",
        "first_name": "SHELLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01063778A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.