Individual provider Active NPI

Paula Rae Shellenbarger, MSN FNP-C

  • Family Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1720011265
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0002850-NP Issued in CO
Practice address
1025 Garfield St
Suite B
Fort Collins, CO 80524
Phone
(970) 495-7420
Fax
(970) 495-7609
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 57965 CO
Family Nurse Practitioner 363LF0000X APN.0002850-NP CO Primary

Addresses

Primary practice location

1025 Garfield St
Suite B
Fort Collins, CO 80524

Mailing address

1025 Garfield St
Suite B
Fort Collins, CO 80524-3930
Phone (970) 495-7420

Other identifiers 1

IdentifierTypeStateIssuer
07321571MedicaidCO

Other names 1

  • Paula Johnson Shellenbarger Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20040109000909 CO Practitioner - Nurse Practitioner 8224938956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
57965COMDNurse Practitioner
APN.0002850-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 28, 2015 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 28, 2015 Accepting new patients
Internal Medicine Clinic Inc. PastSince Dec 6, 2020 Accepting new patients
Value in Prevention of Colorado PLLC PastSince May 1, 2022 Accepting new patients
Joseph M Lopez MD PC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1025 Garfield St
Ste B
Fort Collins, CO 80524
Phone (970) 482-2866

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 5

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1720011265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 GARFIELD ST",
            "address_2": "SUITE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243930",
            "telephone_number": "970-495-7420",
            "fax_number": "970-495-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 GARFIELD ST",
            "address_2": "SUITE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-495-7420",
            "fax_number": "970-495-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBARGER",
        "first_name": "PAULA",
        "middle_name": "RAE",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "57965",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0002850-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07321571",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "SHELLENBARGER",
            "middle_name": "JOHNSON",
            "credential": "MSN FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.