Shelly Broten

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

4909 Shelburne St
Bismarck, ND 58503-5605

Phone

(701) 381-9927

NPI assigned

Dec 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1700544780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035605",
            "telephone_number": "701-381-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035605",
            "telephone_number": "701-381-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTEN",
        "first_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brock Oukrop PC Dba: Dakota Family Smiles
• David A Brooks, PHD
• Tonisha Brooks
• Allan J Brossart
• Tanya Lee Brosz, PHARMD
• Alicia Broussard
• Michael Allen Brousseau, DPT
• Kate S Brovold
• Alexa Brown
• Calie Brown, LAC, LPC, LPCC

• Peer Specialist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Peer Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.