Individual provider Active NPI

Shirley L Wetsel, WHNP

  • Women's Health Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1679654776
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP106544 Issued in TX
Practice address
4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone
(806) 744-7223
Fax
(806) 740-3325
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 597304 TX
Women's Health Nurse Practitioner 363LW0102X AP106544 TX Primary

Addresses

Primary practice location

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Mailing address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Other identifiers 2

IdentifierTypeStateIssuer
044369903MedicaidTX
8N8817OtherTXBXBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swetsel1379966@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050915000921 TX Practitioner - Nurse Practitioner 5294768685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Clinic of LubbockGroup PAC ID 5597768101, 44 clinicians

Practice addresses (Care Compare)

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Clinic of Lubbock CurrentSince Jan 5, 2012 Accepting new patients
Grace Clinic of Lubbock CurrentSince Jan 5, 2012 Accepting new patients

Locations

2804 N Loop 289
Lubbock, TX 79415
Phone (806) 740-3363

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

Interoperability endpoints

  • Direct secure messaging: swetsel1379966@oc.providencedirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1679654776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETSEL",
        "first_name": "SHIRLEY",
        "middle_name": "L",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "597304",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "AP106544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044369903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "8N8817",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swetsel1379966@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.