Individual provider Active NPI

Shelby A Rollings-Gough, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1629677117
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015370 Issued in KY
Practice address
225 Medical Center Dr Ste 303
Paducah, KY 42003-7915
Phone
(270) 444-4222
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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 3015370 KY Primary

Addresses

Primary practice location

225 Medical Center Dr Ste 303
Paducah, KY 42003-7915

Mailing address

225 Medical Center Dr Ste 303
Paducah, KY 42003-7915
Phone (270) 444-4222

Other practice location 1

100 Clint Hill Blvd
Paducah, KY 42001-6771
Phone (270) 450-7229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210402000238 KY Practitioner - Nurse Practitioner 0446667703 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
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

225 Medical Ctr Dr
Suite 303
Paducah, KY 42003-7915
Phone (270) 444-4222

Hospital & facility affiliations

  • Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
  • Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Nov 5, 2023 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Nov 5, 2023 Accepting new patients
Mercy Health Physicians Kentucky LLC Past Accepting new patients

Locations

225 Medical Center Dr
Ste 303
Paducah, KY 42003
Phone (270) 442-9463

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

Interoperability endpoints

  • Direct secure messaging: srollings850453@direct.bsmhealth.org

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 3

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1629677117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 303",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037915",
            "telephone_number": "270-444-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 303",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037915",
            "telephone_number": "270-444-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Clint Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420016771",
            "country_code": "US",
            "telephone_number": "270-450-7229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLINGS-GOUGH",
        "first_name": "SHELBY",
        "middle_name": "A",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.