Eileen Shult, RN,GNP C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

CNP-01549 Issued in NM

Practice address

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Phone

(575) 532-5455

Fax

(575) 532-5641

NPI assigned

May 12, 2006

Last updated

Jul 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eileenshult@sca.allscriptsdirect.net

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.

• Jonathan Ellen MD PC

  • Physical Medicine & Rehabilitation Physician
  • Las Cruces, NM
  • NPI 1851848360
  Medicare reassignment NPD
• Baylor College of Medicine

  dba Baylor College of Medicine Dept of Otolaryngology Head and Neck Cons

  • Otolaryngology Physician
  • Houston, TX
  • NPI 1093880437
  NPD (past)
• Geriatric Associates of America-Texas, PLLC

  • Internal Medicine Physician
  • Webster, TX
  • NPI 1669682886

  Gerontology

  NPD (past)
• Geriatric Associates of America, P.a.

  • Geriatric Medicine (Family Medicine) Physician
  • Houston, TX
  • NPI 1093768673

  Gerontology

  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1578514790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14232",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880134232",
            "telephone_number": "575-532-5455",
            "fax_number": "575-532-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-532-5455",
            "fax_number": "575-532-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULT",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "RN,GNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "672791",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "CNP-01549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175602501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175602502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Shope
• Amber Short
• Jennifer Shoup
• Thakur Shrestha, MD
• Anita Shrivastava, DO
• Dawn Shults
• Isabelo Samson Sicsic Jr.
• Gustavo Vasquez Sida, DMD
• Afrin Ahmed Siddiqui, DDS
• Cindi Siebe, RN LMT

• Gerontology Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Gerontology Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.