Individual provider Active NPI

Shelly J Rodgers, ANP

  • Registered Nurse
  • Red Bluff, CA
National Provider Identifier
1598843807
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
916 Issued in AK
Practice address
2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone
(530) 527-0411
Fax
(530) 527-3720
NPI assigned
Nov 2, 2006
Last updated
Jul 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 916 AK Primary

Addresses

Primary practice location

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356

Mailing address

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone (530) 527-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16008CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory Ian Fields, PH. D. Psychologist, Inc. PastSince Mar 7, 2006 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1598843807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356",
            "telephone_number": "530-527-0411",
            "fax_number": "530-527-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356",
            "telephone_number": "530-527-0411",
            "fax_number": "530-527-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "SHELLY",
        "middle_name": "J",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.