Individual provider Active NPI

Shelby Schermerhorn

  • Physician Assistant
  • Pelican Rapids, MN
National Provider Identifier
1497592091
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
42110 210TH Ave
Pelican Rapids, MN 56572-7426
Phone
(218) 329-6452
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

42110 210TH Ave
Pelican Rapids, MN 56572-7426

Mailing address

42110 210TH Ave
Pelican Rapids, MN 56572-7426
Phone (218) 329-6452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250514002938 MN Practitioner - Physician Assistant 2365960259 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Perham Hospital District CurrentSince Oct 24, 2025 Accepting new patients
Perham Hospital District Current Accepting new patients
Perham Hospital District CurrentSince Oct 24, 2025 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

111 W Vernon Ave
Fergus Falls, MN 56537
Phone (218) 736-5770

712 S Cascade St
Fergus Falls, MN 56537

Organizations & group practices 7

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1497592091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42110 210TH AVE",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565727426",
            "telephone_number": "218-329-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42110 210TH AVE",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565727426",
            "telephone_number": "218-329-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERMERHORN",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelican Rapids, MN

Sources for this page

Verify at the official NPI Registry.