Shelly Earlywine, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010993A Issued in IN

Practice address

1108 Kingwood Dr
Avon, IN 46123-5500

Phone

(317) 941-7338

NPI assigned

Apr 7, 2021

Sex

Female

Sole proprietor

No

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 IN

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Proactive Clinical Partners - AcoGroup PAC ID 5890154884, 30 clinicians

Proactive Clinical PartnersGroup PAC ID 8527315852, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112
• Reid Health Hospital, Richmond, IN, CCN 150048

Merit-based Incentive Payment System (MIPS)

Final score

76.42 of 100Reported as apm

Quality

55.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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.

• Proactive Clinical Partners

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
  • NPI 1366934242
  Medicare reassignment Care Compare group NPD
• Proactive Clinical Partners - Aco

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
  • NPI 1821709031
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Columbus Regional Hospital

  • General Acute Care Hospital
  • Columbus, IN
  • NPI 1104998624
  Care Compare affiliation
• Reid Hospital & Health Care Services, Inc

  dba Reid Health

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1831778760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 DIRECTORS ROW STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414936",
            "telephone_number": "317-941-7338",
            "fax_number": "317-942-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 KINGWOOD DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461235500",
            "telephone_number": "317-941-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLYWINE",
        "first_name": "SHELLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010993A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Lynn Durrett, OTD, OTR/L
• Alex Dykes, RBT
• Jinger Cherri Dykes, MS, OTR
• Amber Lynn Eades, NP
• Gavin Quinn Eaglesfield
• Kristi Easley, MSW
• Edge Medical Services
• Leilah Janeice Edwards
• Katherine Ann Eichelman, DPT
• Vicki Lynn Eklof, MS, OTR

• Family Nurse Practitioner in Avon, IN
• Providers in Avon, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.