Individual provider Active NPI

Shelly Marie Hruby, CNP

  • Pediatric Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1265824239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CP000925 Issued in SD
Practice address
1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 333-2226
NPI assigned
Feb 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000925 SD
Pediatric Nurse Practitioner 363LP0200X CP000925 SD Primary

Addresses

Primary practice location

1305 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

1205 S Grange Ave
Medical Building 2 Suite 104
Sioux Falls, SD 57105-0407
Phone (605) 328-8500

Other practice location 1

1305 W 18th St
Sioux Falls, SD 57105-0401
Phone (605) 333-2226

Other practice location 2

1205 S Grange Ave
Medical Building 2 Suite 104
Sioux Falls, SD 57105-0407
Phone (605) 328-8500

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000925SDMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265824239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S GRANGE AVE",
            "address_2": "MEDICAL BUILDING 2 SUITE 104",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050407",
            "telephone_number": "605-328-8500",
            "fax_number": "605-328-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-333-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571050401",
            "country_code": "US",
            "telephone_number": "605-333-2226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 S Grange Ave",
            "address_2": "Medical Building 2 Suite 104",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571050407",
            "country_code": "US",
            "telephone_number": "605-328-8500",
            "fax_number": "605-328-8501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HRUBY",
        "first_name": "SHELLY",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000925",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SD",
            "license": "CP000925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.