Shelly Lynn Crossman, MSN, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP11069 Issued in AZ

Practice address

448 N State Route 89 Ste H
Chino Valley, AZ 86323-5957

Phone

(928) 499-2915

Fax

(877) 406-3180

NPI assigned

Jul 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shelly Lynn Franz Former name

Medicare fee-for-service enrollment

Enrolled in NY, AZ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelly.crossman@forefrontdermatology.emadirect.md

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.

• Dermatology & Skin Care by Shelly

  • Dermatology Physician
  • Chino Valley, AZ
  • NPI 1720855141
  Medicare reassignment NPD Authorized official
• Dr. Fazeli & Dr. Broumand LLC

  • Dermatology Physician
  • Fayetteville, NY
  • NPI 1336235639
  Medicare reassignment

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

• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1295167484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 WILLOW CREEK RD SUITE A101",
            "address_2": "PO BOX 416",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011673",
            "telephone_number": "928-499-2915",
            "fax_number": "877-406-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 N STATE ROUTE 89 STE H",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235957",
            "telephone_number": "928-499-2915",
            "fax_number": "877-406-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSMAN",
        "first_name": "SHELLY",
        "middle_name": "LYNN",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337984-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11069",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP11069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395116",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "FRANZ",
            "middle_name": "LYNN",
            "credential": "MSN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CL DDS PLLC
• April Rae Clark
• Kiley Lynn Comley, ATC, LAT
• Mark A Costes, D.D.S.
• Laura Brooke Covey, EMT
• Savannah Crowder
• David V Curtis, RPT
• Janet Dahlquist
• Dermatology & Skin Care by Shelly
• Leslie M. Doyle

• Nurse Practitioner in Chino Valley, AZ
• Providers in Chino Valley, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.