Gwendolyn Shelly, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN007411 Issued in PA

Practice address

625 S Duke St
Lancaster, PA 17602-4509

Phone

(717) 299-6371

NPI assigned

Dec 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Gwendolyn Nissley Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Union Community Care 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwendolyn.shelly.1@14261.direct.athenahealth.com

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.

• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1134458789

  PA

  Medicare reassignment Care Compare group NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1417812710
  Care Compare group NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • New Holland, PA
  • NPI 1942437991
  Care Compare group NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1801853346
  Care Compare group NPD (past)
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lebanon, PA
  • NPI 1841785607
  Care Compare group NPD (past)
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • New Holland, PA
  • NPI 1184673790
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lebanon, PA
  • NPI 1225899909
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1366496416
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1396440244
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Columbia, PA
  • NPI 1417715871
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Ephrata, PA
  • NPI 1457002453
  Care Compare group
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1457758617
  Care Compare group

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1881998128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N WATER ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033374",
            "telephone_number": "717-299-6372",
            "fax_number": "717-325-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S DUKE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176024509",
            "telephone_number": "717-299-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "GWENDOLYN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000747-1",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN007411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "NISSLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelby Cordeiro LCSW LLC
• Evan Samuel Shelby, MD
• Latinia Marie Shell, ED.D, LPC, NCC
• Beth P Shelley, OT
• David B Shelley, D.M.D.
• Maryilene Shelly, CRNP
• Robert J Shelly, MD
• Elizabeth Ann Shenk-Wenger, MS
• Doris Anne Shenk, LSW
• Rebecca M Shepherd, M.D.

• All providers in Lancaster, PA
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.