Individual provider Active NPI

Carole E Shelley, M.D.

  • Obstetrics & Gynecology Physician
  • Pocatello, ID
National Provider Identifier
1669462149
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-10122 Issued in ID
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.

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 137 clinicians

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 Hospital, Blackfoot, ID, CCN 131325
  • Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
BMH Inc CurrentSince Feb 19, 2018 Accepting new patients
BMH, Inc. CurrentSince Feb 19, 2018 Accepting new patients
BMH Inc CurrentSince Feb 19, 2018 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

  • Direct secure messaging: caroleshelley@bmh.medalliesdirect.net

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
829335MedicaidAZ
77366OtherIDBLUE CROSS OF IDAHO
808067800MedicaidID
82-0503971OtherIDRAILROAD-MEDICARE

NPI Registry JSON

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

{
    "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

Verify at the official NPI Registry.