Individual provider Active NPI

Shelby Lynn Clark

  • Family Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1487535563
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4042839 Issued in KY
Practice address
225 Medical Center Dr Ste 208B
Paducah, KY 42003-7914
Phone
(270) 444-2444
NPI assigned
Sep 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 4042839 KY Primary

Addresses

Primary practice location

225 Medical Center Dr Ste 208B
Paducah, KY 42003-7914

Mailing address

225 Medical Center Dr Ste 208B
Paducah, KY 42003-7914

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
I20260123003306 KY Practitioner - Nurse Practitioner 5698252203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

1532 Lone Oak Rd
Paducah, KY 42003-7942

225 Medical Ctr Dr
Suite 205
Paducah, KY 42003-7907
Phone (270) 441-4462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4042839KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Jan 11, 2026 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Jan 11, 2026 Accepting new patients
Mercy Health Physicians Kentucky LLC PastSince Sep 14, 2025 Accepting new patients

Locations

225 Medical Center Dr
Ste 208B
Paducah, KY 42003
Phone (270) 391-3050

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1487535563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 208B",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 208B",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037914",
            "telephone_number": "270-444-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHELBY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4042839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.