Tracey Shilman, LICENSED PRACTICAL N

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P012400 Issued in SD

Practice address

3200 Canyon Lake Dr
Rapid City, SD 57702-8114

Phone

(605) 355-2351

NPI assigned

Sep 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1447921945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E SAINT FRANCIS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577035968",
            "telephone_number": "605-545-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CANYON LAKE DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028114",
            "telephone_number": "605-355-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILMAN",
        "first_name": "TRACEY",
        "name_prefix": "Mrs.",
        "credential": "LICENSED PRACTICAL N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SD",
            "license": "P012400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Dwight Shelmadine, D.O, PH.D, CSCS
• Rachel Dawn Shepherd, MSW
• Reena Sheppard, PA-C
• Barbara J Sherard
• Shield Family Chiropractic
• Anuj Shivalingaiah, MD
• Marc Shively, DO
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Haylee Shreeve

• Licensed Practical Nurse in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Licensed Practical Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.