Individual provider Active NPI

Shelby Elise Dobrich, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1255022174
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10008134 Issued in OR
Practice address
44 Club Rd Ste 200
Eugene, OR 97401-2460
Phone
(314) 546-5769
NPI assigned
May 19, 2023
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10008134 OR
Registered Nurse 163W00000X 2018024074 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023007985 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X TEMP76102 ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 293210 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10008134 OR Primary

Addresses

Primary practice location

44 Club Rd Ste 200
Eugene, OR 97401-2460

Mailing address

44 Club Rd Ste 200
Eugene, OR 97401-2460
Phone (314) 546-5769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018024074MOMDRegistered Nurse
10008134ORMDRegistered Nurse
293210AZMDPsychiatric/Mental Health Nurse Practitioner
TEMP76102IDMDPsychiatric/Mental Health Nurse Practitioner
2023007985MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Skycloud Psychiatry LLC Psychiatric/Mental Health Past Accepting new patients

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1255022174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CLUB RD STE 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012460",
            "telephone_number": "314-546-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 CLUB RD STE 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012460",
            "telephone_number": "314-546-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRICH",
        "first_name": "SHELBY",
        "middle_name": "ELISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10008134",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2018024074",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023007985",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "TEMP76102",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "293210",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10008134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.