Individual provider Active NPI

Shelly M Cambell, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1508938515
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP2904272 Issued in FL
Practice address
22065 State Road 7
Boca Raton, FL 33428-4219
Phone
(561) 488-4847
Fax
(561) 488-4366
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ARNP2904272 FL Primary

Addresses

Primary practice location

22065 State Road 7
Boca Raton, FL 33428-4219

Mailing address

22065 State Road 7
Boca Raton, FL 33428-4219
Phone (561) 488-4847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051014000061 FL Practitioner - Nurse Practitioner 4981629342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ima of South Florida LLCGroup PAC ID 6406820414, 30 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 115
Boca Raton, FL 33487-5712
Phone (561) 997-8484

Hospital & facility affiliations

  • Enhabit Home Health of Bethesda Home health agency, Boynton Beach, FL, CCN 107214
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ima of South Florida LLC CurrentSince Sep 4, 2007 Accepting new patients
Docs on Call LLC Past Accepting new patients
Bruce Wishnov DO PA PastSince Mar 5, 2008 Accepting new patients

Locations

6363 Verde Trl
Boca Raton, FL 33433
Phone (561) 226-1885

1601 Clint Moore Rd
Ste 115
Boca Raton, FL 33487
Phone (561) 939-0760

Interoperability endpoints

  • Direct secure messaging: shelly.cambell.1@31574.direct.athenahealth.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508938515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22065 STATE ROAD 7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284219",
            "telephone_number": "561-488-4847",
            "fax_number": "561-488-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22065 STATE ROAD 7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284219",
            "telephone_number": "561-488-4847",
            "fax_number": "561-488-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMBELL",
        "first_name": "SHELLY",
        "middle_name": "M",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2904272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.