Shelly L Betancourt, MSN,MHA,WHNP-BC
Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Carson City, MI
NPI 1962840397 · NPPES record last updated Jun 7, 2013
Key facts
- NPI
- 1962840397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner 363LX0001X
- License
- 4704173045 (MI)
- Practice address
- 639 E Main St
Carson City, MI 48811-9795 - Phone
- (989) 584-3107
- Fax
- (989) 584-6458
- NPI assigned
- Jun 7, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sparrow Carson Hospital
Practice addresses (Care Compare)
639 E Main St
Sparrow Medical Group OBGYN Carson
Carson City, MI 48811-9795
Phone (989) 584-3107
Hospital & facility affiliations
- University of Michigan Health-Sparrow Carson
- Mymichigan Medical Center Clare
- Mymichigan Medical Center Alma
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140115001485 | MI | Practitioner - Nurse Practitioner | 4789812991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sparrow Carson Hospital | Current | Accepting new patients | |
| Sparrow Carson Hospital | Current |
Accepting new patients | |
| Sparrow Carson Hospital | Current |
Accepting new patients | |
| Sparrow Carson Hospital | Past | Accepting new patients |
Locations
8175 Reliable Pkwy
Chicago, IL 60686
1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145
114 N Main St
Ithaca, MI 48847
Phone (989) 875-4166
1210 E Center St
Ithaca, MI 48847
411 W Broadway St
Ste A
Mt Pleasant, MI 48858
Phone (989) 772-7600
306 E Elm St
Ste B
Saint Johns, MI 48879
Phone (989) 224-2100
Interoperability endpoints
- sbetancourt56807@sparrowdirecthie.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 4704173045 | MI | Yes |
Addresses
Primary practice location
639 E Main St
Carson City, MI 48811-9795
Mailing address
639 E Main St
PO Box 670
Carson City, MI 48811-9795
Phone (989) 584-3107
Other providers in Carson City, MI
- Rena Baxter
- Michelle Leigh Becher
- Amanda Elizabeth Bennett
- Sarah A Bergakker
- Alberto Betancourt
- Parut R Bhimalli
- Bobbie'S Helping Hands Home Care
- Kristi Ann Brethauer
- Calm Reflections LLC
- Carson City Center for Women'S Healthcare PC
All providers in Carson City, MI · Obstetrics & Gynecology Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.