NPIMap

Individual provider Active NPI

Shelley Naomi, PAC

  • Physician Assistant
  • Kalispell, MT
National Provider Identifier
1871694463
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
26604 Issued in MT
Practice address
160 Heritage Way Ste 202
Kalispell, MT 59901-3127
Phone
(406) 752-8433
NPI assigned
Sep 26, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 26604 MT Primary
Physician Assistant 363A00000X 1935 WI
Physician Assistant 363A00000X 464 WY

Addresses

Primary practice location

160 Heritage Way Ste 202
Kalispell, MT 59901-3127

Mailing address

PO Box 912491
Denver, CO 80291-2491
Phone (307) 773-8133

Other practice location 1

433 E 19th St
Cheyenne, WY 82001-4643
Phone (307) 773-8133

Other identifiers 1

IdentifierTypeStateIssuer
42882400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200427002395 MT Practitioner - Physician Assistant 4082622071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

306 Stoner Loop
Lakeside, MT 59922-8600
Phone (406) 844-0541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1546NEMDChiropractor
26604MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Sep 7, 2025 Accepting new patients
Glacier Ultrasound Service LLC CurrentSince Jan 15, 2019 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Michael a Amadei M.D PC Past Accepting new patients
Neil Singer MD PLLC Past Accepting new patients
Cheyenne Regional Urgent Care, LLC Past Accepting new patients

Locations

160 Heritage Way
Ste 202
Kalispell, MT 59901
Phone (406) 752-8433

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

306 Stoner Loop
Lakeside, MT 59922
Phone (406) 751-7150

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871694463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912491",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912491",
            "telephone_number": "307-773-8133",
            "fax_number": "307-432-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY STE 202",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013127",
            "telephone_number": "406-752-8433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 E 19th St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014643",
            "country_code": "US",
            "telephone_number": "307-773-8133",
            "fax_number": "307-432-3618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAOMI",
        "first_name": "SHELLEY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "26604",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1935",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42882400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "160 Heritage Way Ste 202",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.