Beverly Ann Shell, LPN-NURSE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN15624 Issued in NV

Practice address

Fort McDermitt Wellness Center
Suite 702G
McDermitt, NV 98421

Phone

(775) 532-8522

Fax

(775) 575-2384

NPI assigned

Feb 15, 2016

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1942669338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 EISENHOWER AVENUE",
            "address_2": "155 EISENHOWER AVENUE",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "89445",
            "telephone_number": "775-304-2081",
            "fax_number": "775-575-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORT MCDERMITT WELLNESS CENTER",
            "address_2": "SUITE 702G",
            "city": "MCDERMITT",
            "state": "NV",
            "postal_code": "98421",
            "telephone_number": "775-532-8522",
            "fax_number": "775-575-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELL",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN-NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "LPN15624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ft. McDermitt Paiute-Shoshone Tribe (Ft. McDermitt Wellness Center)
• Michael Dion Garfield, EMT-I
• Brandon Joseph Grow, EMT PARAMEDIC
• Tracy Marshall
• Stacy Irene Rust, RN
• Thelma Rose Simon, LADC, BSW
• Merry Christine Trujillo, EMT-I
• Usphs, Indian Health Service, Schurz

• Licensed Practical Nurse in McDermitt, NV
• Providers in McDermitt, NV by specialty
• Licensed Practical Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.