Individual provider Active NPI

Shelly Nestor

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Phoenix, AZ
National Provider Identifier
1407068364
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081H0002X
License
0045 Issued in AZ
Practice address
11616 N. 41 Dr.
Phoenix, AZ 85029
Phone
(602) 299-8981
NPI assigned
May 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X 0045 AZ Primary

Addresses

Primary practice location

11616 N. 41 Dr.
Phoenix, AZ 85029

Mailing address

11616 N. 41 Dr.
Phoenix, AZ 85029
Phone (602) 299-8981

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0045AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407068364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11616 N. 41 DR.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-299-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 N. 41 DR.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "602-299-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTOR",
        "first_name": "SHELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "AZ",
            "license": "0045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.