Kelly S. Shultz, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

UP004718B Issued in PA

Practice address

215 E Water St
Susquehanna Health Skilled Nursing & Rehab Center
Muncy, PA 17756-8828

Phone

(570) 546-4040

Fax

(570) 546-4095

NPI assigned

May 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1467410340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E WATER ST",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177568828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WATER ST",
            "address_2": "SUSQUEHANNA HEALTH SKILLED NURSING & REHAB CENTER",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177568828",
            "telephone_number": "570-546-4040",
            "fax_number": "570-546-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "KELLY",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "UP004718B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073317020002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian D Shiptoski, CRNP
• Jennifer Shirey, PA-C
• Lashanna Rochelle Short, MSOTR/L
• Shuler Foot Care Center Inc
• Hallie Ann Shuler, D.P.M.
• Alanna Leigh Siverling, RD, LDN
• Jennifer C Skow, PA-C
• John Slodysko
• Denise Michelle Snodgrass, RPH
• Sheryl Snyder-Everitt

• Nurse Practitioner in Muncy, PA
• Providers in Muncy, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.