Kelli J Shidler, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23204 Issued in NE

Practice address

17675 Welch PLZ
Omaha, NE 68135-3551

Phone

(402) 354-7630

Fax

(402) 354-7635

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Kelli J Pauling Former name

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Father Flanagan'S Boys' Home

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825
  Medicare reassignment NPD
• Physicians Clinic Inc

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156

  Pediatrics

  Medicare reassignment NPD
• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  NPD (past)
• Father Flanagan'S Boys' Home

  • Children's Hospital
  • Omaha, NE
  • NPI 1457458556
  NPD (past)
• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1285794040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17675 WELCH PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681353551",
            "telephone_number": "402-354-7630",
            "fax_number": "402-354-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIDLER",
        "first_name": "KELLI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "23204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "251093",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "01516",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "PAULING",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassandra Shevela, OTD
• Bridget M Shevlin, MT-BC
• Timothy Shew, PA
• Ma Thu Shia
• Kenjiro Shibuya
• Jaquita Shields
• Joan Shields
• Jocelyn R Shields
• Jonathan McClain Shields, MD
• Julia Shields

• Pediatrics Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.