Active NPI
Shelby Renee Brunson
- Family Nurse Practitioner
- Rexburg, ID
National Provider Identifier
1861296485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5071472
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5071472 | ID | MD | Family Nurse Practitioner |
| 76133 | ID | MD | Student in an Organized Health Care Education/Training Program |
| RN60557241 | WA | MD | Student 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.
-
- Rural Health Clinic/Center
- Rexburg, ID
- NPI 1407564123
-
- Rural Health Clinic/Center
- Chubbuck, ID
- NPI 1477200244
-
- Rural Health Clinic/Center
- Burley, ID
- NPI 1659915593
-
- Rural Health Clinic/Center
- Hailey, ID
- NPI 1912541863
-
- Rural Health Clinic/Center
- Idaho Falls, ID
- NPI 1952923765
-
- Rural Health Clinic/Center
- Evanston, WY
- NPI 1164044962
-
- Rural Health Clinic/Center
- Richmond, UT
- NPI 1164066015
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.