Shelby Knapp, FNP
Individual provider Active NPI Nurse Practitioner · Bolivar, NY
NPI 1750154886 · NPPES record last updated Apr 13, 2026
Key facts
- NPI
- 1750154886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 353072 (NY)
- Practice address
- 120 1St St
Bolivar, NY 14715-1132 - Phone
- (585) 928-1600
- NPI assigned
- Oct 31, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240514000322 | NY | Practitioner - Nurse Practitioner | 6103267745 | Reassigns benefits to 2 organizations |
| I20250718000678 | PA | Practitioner - Nurse Practitioner | 6103267745 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F353072 | NY | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Near Me Dermatology PLLC | Multi-Specialty | Current |
Accepting new patients |
| Clinical Practice of Lecom Institute for Successful Living | Multi-Specialty | Current |
Accepting new patients |
| Clinical Practice of Lecom Institute for Successful Living | Multi-Specialty | Current |
Accepting new patients |
| The Memorial Hospital of William F. and Gertrude F. Jones, Inc. | Current |
Accepting new patients | |
| The Memorial Hospital of William F. and Gertrude F. Jones, Inc. | Multi-Specialty | Current |
Accepting new patients |
Locations
5210 Linton Blvd
Ste 307
Delray Beach, FL 33484
Phone (561) 499-0660
112 W Main St
Allegany, NY 14706
Phone (716) 373-0700
120 1st St
Bolivar, NY 14715
Phone (585) 928-1600
329 Hewes St
Brooklyn, NY 11211
Phone (718) 384-3475
73 Buffalo St
Ste 100
Canandaigua, NY 14424
609 Central Ave
Dunkirk, NY 14048
Phone (716) 363-6960
191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100
5401 Peach St
Erie, PA 16509
Phone (814) 868-2170
5535 Peach St
Erie, PA 16509
Phone (814) 868-3488
5401 Peach St
Ste 3400
Erie, PA 16509
Phone (814) 868-2200
16954 Conneaut Lake Rd
Meadville, PA 16335
Phone (814) 200-9904
Interoperability endpoints
- sknapp@lisl.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | F353072 | NY | |
| Nurse Practitioner |
363L00000X | 353072 | NY | Yes |
Addresses
Primary practice location
120 1St St
Bolivar, NY 14715-1132
Mailing address
PO Box 592
Eldred, PA 16731-0592
Other providers in Bolivar, NY
- Ruth M Faust
- Katy M Gerrity
- Yuko Gilbert
- Victoria M Hefner
- Sara Johnson
- Julie Lorraine Meyer
- Racheal Murray
- Portville Pharmacy Inc
- Portville Pharmacy,Inc.
- Rhonda Lee Slocum
All providers in Bolivar, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.