Shelby Rigdon Tieken, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1028643 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104-4917

Phone

(817) 702-1100

NPI assigned

Feb 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Southlake Medical Center Hospital, Southlake, TX, CCN 670132

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment Care Compare group NPD
• Dallas Pulmonary & Critical Care PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1235402728

  Acute Care

  Medicare reassignment Care Compare group NPD

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

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Southlake, TX
  • NPI 1568818417
  Care Compare affiliation

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1255924064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 N MacArthur Blvd",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750612220",
            "country_code": "US",
            "telephone_number": "972-579-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEKEN",
        "first_name": "SHELBY",
        "middle_name": "RIGDON",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-12",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1028643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "817-319-6760",
            "affiliation": "N",
            "endpointDescription": "cell",
            "address_1": "1901 N MacArthur Blvd",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750612220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tristin Tice
• Rachael Ticer, MS
• Heath William Hall Tidwell
• Olivia Tidwell
• Jana Tieding, CCC-SLP
• Kevin Wells Tien, MD
• Tate Lundy Tieperman, PT, DPT
• Millard Lucien Tierce IV, D.O.
• Nancy A Tierney, NP
• Samantha Judith Tierney

• Acute Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.