Individual provider Active NPI

Brooke Holly Shelton, FNP-BC

  • Nurse Practitioner
  • Pleasant Grove, UT
National Provider Identifier
1942999511
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10408063-4405 Issued in UT
Practice address
830 N 2000 W
Pleasant Grove, UT 84062-4047
Phone
(801) 208-8850
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10408063-4405 UT Primary

Addresses

Primary practice location

830 N 2000 W
Pleasant Grove, UT 84062-4047

Mailing address

659 E Wyngate Pointe LN
Draper, UT 84020-9695
Phone (801) 208-8850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20240923003384 UT Practitioner - Nurse Practitioner 4688115272 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
Group practices
Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

830 N 2000
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Medical - City Center Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Premier Family Medical Family Medicine Current Accepting new patients
Premier Family Medical - American Fork Physical Therapy CurrentSince Oct 1, 2024 Accepting new patients

Locations

226 N 1100 E
American Fork, UT 84003
Phone (801) 855-3840

3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 443-1184

573 W Sunrise Way
Unit 102
Lehi, UT 84048
Phone (801) 642-2990

3000 N Triumph Blvd
Ste 220
Lehi, UT 84043
Phone (801) 642-2990

680 E Main St
Lehi, UT 84043
Phone (801) 766-0606

275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333

830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511

62 E Thrive Dr
Ste 100
Saratoga Springs, UT 84045
Phone (801) 766-8427

707 E Mill Rd
Ste 303
Vineyard, UT 84059
Phone (801) 224-1300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1942999511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 E WYNGATE POINTE LN",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209695",
            "telephone_number": "801-208-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N 2000 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624047",
            "telephone_number": "801-208-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "BROOKE",
        "middle_name": "HOLLY",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "10408063-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.