Individual provider Active NPI

Danielle Shellman

  • Acute Care Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1932928579
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5021003 Issued in NC
Practice address
205 Page Rd
Pinehurst, NC 28374-8798
Phone
(910) 295-9359
NPI assigned
Oct 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5021003 NC Primary

Addresses

Primary practice location

205 Page Rd
Pinehurst, NC 28374-8798

Mailing address

724 Kensington Park Rd
Fayetteville, NC 28311-2983
Phone (678) 469-9612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241106000616 NC Practitioner - Nurse Practitioner 5799219374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5021003NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Oct 21, 2024 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

Interoperability endpoints

  • Direct secure messaging: danielleshellman@phmc.allscriptsdirect.net

Organizations & group practices 2

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 4

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": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1932928579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 KENSINGTON PARK RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112983",
            "telephone_number": "678-469-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748798",
            "telephone_number": "910-295-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLMAN",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5021003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.