NPIMap

Individual provider Active NPI

Shelby Jean Bare, CRNP

  • Family Nurse Practitioner
  • Hanover, PA
National Provider Identifier
1558979062
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022240 Issued in PA
Practice address
111 Penn St Ste 1
Hanover, PA 17331-1953
Phone
(717) 632-4449
Fax
(717) 633-3553
NPI assigned
Jul 21, 2020
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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 SP022240 PA Primary

Addresses

Primary practice location

111 Penn St Ste 1
Hanover, PA 17331-1953

Mailing address

100 Penn St Ste D
Hanover, PA 17331-1956
Phone (717) 632-0774

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbare@hanoverfamilypractice.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803002358 PA Practitioner - Nurse Practitioner 5991121931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hanover Family Practice Associates, LLCGroup PAC ID 1850299587, 15 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

111 Penn St
Hanover, PA 17331-1959
Phone (717) 632-4449

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Family Practice Associates, LLC CurrentSince Jul 6, 2020 Accepting new patients

Locations

100 Penn St
Ste D
Hanover, PA 17331
Phone (717) 632-0774

111 Penn St
Hanover, PA 17331
Phone (717) 632-0774

111 Penn St
Ste 1
Hanover, PA 17331
Phone (717) 632-4449

112 Clover Ln
Hanover, PA 17331
Phone (717) 632-4449

Interoperability endpoints

  • Direct secure messaging: sbare445245@wellspan.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1558979062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PENN ST STE D",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311956",
            "telephone_number": "717-632-0774",
            "fax_number": "717-633-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PENN ST STE 1",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311953",
            "telephone_number": "717-632-4449",
            "fax_number": "717-633-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARE",
        "first_name": "SHELBY",
        "middle_name": "JEAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbare@hanoverfamilypractice.com",
            "affiliation": "N",
            "endpointDescription": "provider email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "IDK",
            "address_1": "111 Penn St Ste 1",
            "city": "Hanover",
            "state": "PA",
            "country_code": "US",
            "postal_code": "173311953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.