Individual provider Active NPI

Shelby Renee Brunson

  • Family Nurse Practitioner
  • Rexburg, ID
National Provider Identifier
1861296485
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5071472 Issued in ID
Practice address
1750 Clements LN
Rexburg, ID 83440-5352
Phone
(509) 531-2548
NPI assigned
Apr 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5071472 ID Primary
Student in an Organized Health Care Education/Training Program 390200000X RN60557241 WA
Student in an Organized Health Care Education/Training Program 390200000X 76133 ID

Addresses

Primary practice location

1750 Clements LN
Rexburg, ID 83440-5352

Mailing address

1750 Clements LN
Rexburg, ID 83440-5352
Phone (509) 531-2548

Other names 1

  • Shelby R Johns 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
I20260407002456 ID Practitioner - Nurse Practitioner 7113492182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Provider Group 52 clinicians

Practice addresses (Care Compare)

260 E Moody Rd
Rexburg, ID 83440-5531
Phone (208) 656-3553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5071472IDMDFamily Nurse Practitioner
76133IDMDStudent in an Organized Health Care Education/Training Program
RN60557241WAMDStudent in an Organized Health Care Education/Training Program

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1861296485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 CLEMENTS LN",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405352",
            "telephone_number": "509-531-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 CLEMENTS LN",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405352",
            "telephone_number": "509-531-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "SHELBY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "5071472",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "RN60557241",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": "76133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "JOHNS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.