Active NPI
Carole E Shelley, M.D.
- Obstetrics & Gynecology Physician
- Pocatello, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- M-10122
- Practice address
- 777 Hospital Way
Suite 300
Pocatello, ID 83201-5176 - Phone
- (208) 239-3461
- Fax
- (208) 239-3425
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
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.
-
- Rural Health Clinic/Center
- Blackfoot, ID
- NPI 1770785875
-
- Rural Health Clinic/Center
- Shelley, ID
- NPI 1366630949
-
- Medicare Defined Swing Bed Hospital Unit
- Blackfoot, ID
- NPI 1689876781
-
- Rural Health Clinic/Center
- Blackfoot, ID
- NPI 1922243088
-
- Skilled Nursing Facility
- Blackfoot, ID
- NPI 1861694960
-
- Family Medicine Physician
- Idaho Falls, ID
- NPI 1174091896
-
- Family Medicine Physician
- Pocatello, ID
- NPI 1295502995
-
- Specialist
- Denver, CO
- NPI 1659496552
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- BMH Inc
Practice addresses (Care Compare)
315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990
98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100
Hospital & facility affiliations
- Bingham Memorial Hospital
- Portneuf Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080725000414 | ID | Practitioner - Obstetrics/Gynecology | 7517852270 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BMH Inc | Current | Accepting new patients | |
| BMH, Inc. | Current | Accepting new patients | |
| BMH Inc | Current | Accepting new patients | |
| BMH, Inc. | Current | Accepting new patients | |
| BMH Inc. | Past | Accepting new patients | |
| Women'S Clinic at Cherry Creek | Past | Accepting new patients |
Locations
315 W Idaho St
Blackfoot, ID 83221
Phone (208) 782-3990
98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763
777 Hospital Way
Ste 300
Pocatello, ID 83201
Phone (208) 232-6100
Interoperability endpoints
- caroleshelley@bmh.medalliesdirect.net
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 31911 | AZ | |
| Obstetrics & Gynecology Physician | 207V00000X | M-10122 | ID | Primary |
Addresses
Primary practice location
777 Hospital Way
Suite 300
Pocatello, ID 83201-5176
Mailing address
777 Hospital Way
Sutie 300
Pocatello, ID 83201-5176
Phone (208) 239-3461
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 829335 | Medicaid | AZ | |
| 77366 | Other | ID | BLUE CROSS OF IDAHO |
| 808067800 | Medicaid | ID | |
| 82-0503971 | Other | ID | RAILROAD-MEDICARE |
NPI Registry JSON
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342656000000",
"number": "1669462149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 HOSPITAL WAY",
"address_2": "SUTIE 300",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015176",
"telephone_number": "208-239-3461",
"fax_number": "208-239-3425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 HOSPITAL WAY",
"address_2": "SUITE 300",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015176",
"telephone_number": "208-239-3461",
"fax_number": "208-239-3425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEY",
"first_name": "CAROLE",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-25",
"last_updated": "2012-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AZ",
"license": "31911",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "ID",
"license": "M-10122",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "829335",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "77366",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "808067800",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD-MEDICARE",
"identifier": "82-0503971",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.