Shelly Ann Boston, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

78693 Issued in OK

Practice address

216 S 7TH St
Suite 1
Vinita, OK 74301-3742

Phone

(918) 256-1501

Fax

(918) 323-0460

NPI assigned

Jul 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Tribal Health SystemGroup PAC ID 7911893854, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Northeastern Tribal Health System

  • Clinic/Center
  • Miami, OK
  • NPI 1871522532
  Care Compare group
• Integris Grove Hospital

  • Rural Health Clinic/Center
  • Grove, OK
  • NPI 1134720592
  NPD
• Integris Miami Hospital

  • Rural Health Clinic/Center
  • Miami, OK
  • NPI 1912508375
  NPD
• Integris Baptist Regional Health Center

  • Emergency Care Clinic/Center
  • Miami, OK
  • NPI 1811952963
  NPD (past)

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1932487022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SOUTH 7TH STREET",
            "address_2": "SUITE 1",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013720",
            "telephone_number": "918-256-1501",
            "fax_number": "918-323-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S 7TH ST",
            "address_2": "SUITE 1",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013742",
            "telephone_number": "918-256-1501",
            "fax_number": "918-323-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "78693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "200509690H",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200390480A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonessa Blackfox, LPN
• Francis Rollin Bland, M.D.
• Brianna Elaina Bloom
• Jeanette Bolte
• Angela Boston, PHARM D.
• Austin R Bowers
• Billy Joe Bowers Jr.
• Rylie Bowin
• Joseph Michael Bowman
• Bryan Box

• Family Nurse Practitioner in Vinita, OK
• Providers in Vinita, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.

Verify at the official NPI Registry.