Shelly Churchill

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11017691 Issued in FL

Practice address

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Phone

(813) 745-4673

Fax

(813) 745-3540

NPI assigned

Jan 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer SCRN Ctr IncGroup PAC ID 2264337021, 1,145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
• Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

  • Hematology & Oncology Physician
  • Tampa, FL
  • NPI 1306833595
  Medicare reassignment Care Compare group NPD
• Guidewell Sanitas I, LLC

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Florida Hospital Zephyrhills Inc

  • General Acute Care Hospital
  • Zephyrhills, FL
  • NPI 1346354677
  Care Compare affiliation
• Pasco-Pinellas Hillsborough Community Health System Inc

  • General Acute Care Hospital
  • Wesley Chapel, FL
  • NPI 1073893020
  Care Compare affiliation

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1720731813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-4673",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-4673",
            "fax_number": "813-745-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "SHELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11017691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Chuppe
• Jazmine L Church
• Kimberly E Church, PSYD
• Tarik N Church, ATC
• Alisha M Churchill, PT
• Wendy Churchill, DMD
• Amanda Behl Chute, RN
• Kevin Cialfi, DO
• Christine Marie Ciaramella, PHARMD
• Joseph Ciccarello, DC

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.