Active NPI
Shelly Vice, RN, BSN
- Registered Nurse
- Bloomington, IN
National Provider Identifier
1841826328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28110751A
- Practice address
- 1932 S Oakdale Dr
Bloomington, IN 47403-2985 - Phone
- (812) 320-6625
- NPI assigned
- Mar 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28110751A | IN | Primary |
Addresses
Primary practice location
1932 S Oakdale Dr
Bloomington, IN 47403-2985
Mailing address
PO Box 2105
Bloomington, IN 47402-2105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28110751A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584403200000",
"number": "1841826328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2105",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474022105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1932 S OAKDALE DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032985",
"telephone_number": "812-320-6625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICE",
"first_name": "SHELLY",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-17",
"last_updated": "2020-03-17",
"certification_date": "2020-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28110751A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.