Individual provider Active NPI

Shelley Jo Folsom, WHNP-BC

  • Women's Health Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1821758913
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
70296 Issued in ID
Practice address
535 W Sunnyside Rd
Idaho Falls, ID 83402-4643
Phone
(208) 529-2019
Fax
(208) 392-4095
NPI assigned
Dec 30, 2021
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 70296 ID Primary

Addresses

Primary practice location

535 W Sunnyside Rd
Idaho Falls, ID 83402-4643

Mailing address

2380 E Alexis Ave
Idaho Falls, ID 83401-4724
Phone (208) 312-3999

Other names 1

  • Shelley Jo Searle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20221025003360 ID Practitioner - Nurse Practitioner 8022484427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monarch Healthcare PLLCGroup PAC ID 4981922309, 10 clinicians

Practice addresses (Care Compare)

1660 John Adams Pkwy
Idaho Falls, ID 83401-4360
Phone (208) 523-8844

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Healthcare PLLC Obstetrics & Gynecology CurrentSince Oct 1, 2022 Accepting new patients
Utah Fertility Center PastSince Jan 2, 2022 Accepting new patients

Locations

2990 Cortez Ave
Idaho Falls, ID 83404
Phone (208) 535-0440

2060 S Woodruff Ave
Idaho Falls, ID 83404
Phone (208) 523-7246

1660 John Adams Pkwy
Idaho Falls, ID 83401
Phone (208) 523-8844

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCHJDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1821758913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 E ALEXIS AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014724",
            "telephone_number": "208-312-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W SUNNYSIDE RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024643",
            "telephone_number": "208-529-2019",
            "fax_number": "208-392-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "SHELLEY",
        "middle_name": "JO",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "70296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "SEARLE",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.