Active NPI
Michelle Lynn Shellhaas, PT
- Physical Therapist
- Elkhorn, NE
National Provider Identifier
1417901562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2820
- Practice address
- 717 N 190TH PLZ
Suite 2000
Elkhorn, NE 68022-3913 - Phone
- (402) 815-2061
- Fax
- (402) 815-2062
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6494 | AZ | |
| Physical Therapist | 225100000X | 9585 | CO | |
| Physical Therapist | 225100000X | 2820 | NE | Primary |
Addresses
Primary practice location
717 N 190TH PLZ
Suite 2000
Elkhorn, NE 68022-3913
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025941700 | Medicaid | NE | |
| 10026252200 | Medicaid | NE | |
| 1417901562 | Medicaid | IA | |
| 10025896100 | Medicaid | NE | |
| 10026056700 | Medicaid | NE | |
| 10025895900 | Medicaid | NE | |
| 10025896000 | Medicaid | NE |
Other names 1
- Michelle Lyn Brown
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6494 | AZ | MD | Trauma Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1417901562",
"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": "717 N 190TH PLZ",
"address_2": "SUITE 2000",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680223913",
"telephone_number": "402-815-2061",
"fax_number": "402-815-2062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLHAAS",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "6494",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "9585",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025941700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026252200",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1417901562",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025896100",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026056700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025895900",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025896000",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "BROWN",
"middle_name": "LYN",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elkhorn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.