Individual provider Active NPI

Shelley C Waldman, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1376971168
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007715 Issued in KY
Practice address
2400 Eastpoint Pkwy Ste 350
Louisville, KY 40223-4154
Phone
(502) 259-8970
Fax
(502) 259-8971
NPI assigned
Oct 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007715 KY Primary

Addresses

Primary practice location

2400 Eastpoint Pkwy Ste 350
Louisville, KY 40223-4154

Mailing address

5200 Commerce Crossings Dr FL 3
Louisville, KY 40229-2182
Phone (502) 253-4900

Other identifiers 1

IdentifierTypeStateIssuer
7100263340MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20131119001309 KY Practitioner - Nurse Practitioner 1557597622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

3900 Kresge Way
Suite 41
Louisville, KY 40207-4681
Phone (502) 899-3623

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 1, 2020 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Komg-Louisville Region Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

2400 Eastpoint Pkwy
Ste 350
Louisville, KY 40223
Phone (502) 259-8970

3920 Dutchmans Ln
Ste 300
Louisville, KY 40207
Phone (502) 587-4515

Interoperability endpoints

  • Direct secure messaging: swaldman28051@bhkydirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1376971168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EASTPOINT PKWY STE 350",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234154",
            "telephone_number": "502-259-8970",
            "fax_number": "502-259-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "SHELLEY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-15",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100263340",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.