Shelby Elaine Gibson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

122181 Issued in AR

Practice address

507 N Church St Ste a
Monticello, AR 71655-4316

Phone

(870) 888-7768

NPI assigned

Dec 5, 2019

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Elaine McMickle Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

State licenses

Practice roles

Locations

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.

• Integrated Wound Care Arkansas PLLC

  • General Practice Physician
  • Little Rock, AR
  • NPI 1760110282

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1659918936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 GIBSON RD",
            "city": "RISON",
            "state": "AR",
            "postal_code": "716658284",
            "telephone_number": "870-723-5697",
            "fax_number": "870-252-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N CHURCH ST STE A",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554316",
            "telephone_number": "870-888-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHELBY",
        "middle_name": "ELAINE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "122181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "MCMICKLE",
            "middle_name": "ELAINE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April Gardner
• Kierra Gardner
• Trace Nathaniel Garner, M.D.
• Jason E Gault, DO
• Ggnsc Monticello LLC (Golden LivingCenter - Monticello)
• Whitney Gifford
• April Brandy Glasscock, APRN, PMHNP
• Kellie Gober, LMSW
• Ashley Goggans, PTA
• Shanae Govan

• Family Nurse Practitioner in Monticello, AR
• Providers in Monticello, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.