NPIMap

Individual provider Active NPI

Shelby Malin Casper, FNP-C

  • Family Nurse Practitioner
  • Lamar, CO
National Provider Identifier
1821563016
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0994194-NP Issued in CO
Practice address
403 Kendall Dr
Lamar, CO 81052-3953
Phone
(719) 336-6767
Fax
(719) 336-7217
NPI assigned
Oct 4, 2018
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0994194-NP CO Primary

Addresses

Primary practice location

403 Kendall Dr
Lamar, CO 81052-3953

Mailing address

32770 County Road 17
Las Animas, CO 81054-9464
Phone (719) 688-9962

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehr-direct@prowersmedicalcenterclinic.hin.us

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120001534 CO Practitioner - Nurse Practitioner 2062766553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

201 Kendall Dr
Lamar, CO 81052-3939
Phone (719) 336-0261

36053 US Hwy 287
Wiley, CO 81092-9702
Phone (719) 829-4030

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County Line Health Clinic Family CurrentSince Jan 3, 2022 Accepting new patients

Locations

36053 US Highway 287
Wiley, CO 81092
Phone (719) 468-6395

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24285/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shelby.casper.1@24285.direct.athenahealth.com

Organizations & group practices 2

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 6

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1821563016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32770 COUNTY ROAD 17",
            "city": "LAS ANIMAS",
            "state": "CO",
            "postal_code": "810549464",
            "telephone_number": "719-688-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 KENDALL DR",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523953",
            "telephone_number": "719-336-6767",
            "fax_number": "719-336-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASPER",
        "first_name": "SHELBY",
        "middle_name": "MALIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994194-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehr-direct@prowersmedicalcenterclinic.hin.us",
            "affiliation": "N",
            "address_1": "403 Kendall Dr",
            "city": "LaMar",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810523953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lamar, CO

Sources for this page

Verify at the official NPI Registry.