Individual provider Active NPI

Shelrel F Berry, APRN

  • Advanced Practice Midwife
  • Panama City, FL
National Provider Identifier
1689690943
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11012787 Issued in FL
Practice address
103 E 23Rd St
Panama City, FL 32405-4501
Phone
(850) 769-0338
Fax
(850) 640-2195
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN11012787 FL Primary
Advanced Practice Midwife 367A00000X 1052673 AL

Addresses

Primary practice location

103 E 23Rd St
Panama City, FL 32405-4501

Mailing address

PO Box 9100
Belfast, ME 04915-9100
Phone (561) 300-2410

Other practice location 1

1806 Fairview Ave
Dothan, AL 36301-3026
Phone (334) 677-5986

Other identifiers 3

IdentifierTypeStateIssuer
51534465OtherBLUE CROSS BLUE SHIELD
51545741MedicaidAL
891013060MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816002240 FL Practitioner - Certified Nurse Midwife (CNM) 3678593662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
1052673ALMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC CurrentSince Oct 1, 2021 Accepting new patients
Womencare PA Past Accepting new patients
Azalea Physicians for Women, P.C. Past Accepting new patients

Locations

199 S US Highway 17
East Palatka, FL 32131
Phone (386) 325-6699

103 E 23rd St
Panama City, FL 32405
Phone (850) 769-0338

1002 N Arnold Rd
Unit 303
Panama City Beach, FL 32413
Phone (850) 769-0338

Interoperability endpoints

  • Direct secure messaging: shelrel.berry.1@2183.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1689690943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9100",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159100",
            "telephone_number": "561-300-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054501",
            "telephone_number": "850-769-0338",
            "fax_number": "850-640-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1806 Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363013026",
            "country_code": "US",
            "telephone_number": "334-677-5986",
            "fax_number": "334-677-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SHELREL",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11012787",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AL",
            "license": "1052673",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51534465",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51545741",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891013060",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.