Individual provider Active NPI

Shala Marie Caudill

  • Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1730930611
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2026011637 Issued in MO
Practice address
2421 W 21St St Ste B
Clovis, NM 88101-2006
Phone
(620) 259-0903
NPI assigned
Mar 29, 2024
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 2026011637 MO Primary
Nurse Practitioner 363L00000X 78291 NM

Addresses

Primary practice location

2421 W 21St St Ste B
Clovis, NM 88101-2006

Mailing address

2421 W 21St St Ste B
Clovis, NM 88101-2006
Phone (620) 259-0903

Other practice location 1

3265 NE Ralph Powell Rd
Lees Summit, MO 64064-2301
Phone (913) 754-5092

Other names 1

  • Shala Marie Ritcha Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240610001804 NM Practitioner - Nurse Practitioner 0749722429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2421 W 21St St
Suite B
Clovis, NM 88101-2006
Phone (575) 769-7577

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2026011637MOMDNurse Practitioner
78291NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Multi-Specialty CurrentSince May 21, 2024 Accepting new patients
Presbyterian Healthcare Services Multi-Specialty CurrentSince May 21, 2024 Accepting new patients
Presbyterian Healthcare Services Multi-Specialty Past Accepting new patients

Locations

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2421 W 21st St
Ste B
Clovis, NM 88101
Phone (575) 742-7824

Interoperability endpoints

  • Direct secure messaging: scaudill250467@direct.phs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1730930611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 W 21ST ST STE B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012006",
            "telephone_number": "620-259-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 W 21ST ST STE B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012006",
            "telephone_number": "620-259-0903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3265 NE Ralph Powell Rd",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640642301",
            "country_code": "US",
            "telephone_number": "913-754-5092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "SHALA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2026011637",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "78291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHALA",
            "last_name": "RITCHA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.