Individual provider Active NPI

Shelby Lynn Ernest, NP

  • Family Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1962998096
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R31203 Issued in ND
Practice address
5049 33Rd Ave S
Fargo, ND 58104-7080
Phone
(701) 356-1001
Fax
(701) 639-4550
NPI assigned
Jul 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R31203 ND Primary

Addresses

Primary practice location

5049 33Rd Ave S
Fargo, ND 58104-7080

Mailing address

5049 33Rd Ave S
Fargo, ND 58104-7080
Phone (701) 356-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20180813001689 ND Practitioner - Nurse Practitioner 4385992049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dakota Gastroenterology, LTDGroup PAC ID 5991921504, 5 clinicians

Practice addresses (Care Compare)

5049 33Rd Ave S
Fargo, ND 58104-7080
Phone (701) 365-1001

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Essentia Health Hospital, Fargo, ND, CCN 350070
  • Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
  • Sanford Mayville Hospital, Mayville, ND, CCN 351309

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Gastroenterology, LTD CurrentSince Jan 9, 2023 Accepting new patients
Dakota Gastroenterology, LTD CurrentSince Jan 9, 2023 Accepting new patients

Locations

5049 33rd Ave S
Fargo, ND 58104
Phone (701) 356-1001

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.

Hospital & facility affiliations 10

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": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1962998096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5049 33RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047080",
            "telephone_number": "701-356-1001",
            "fax_number": "701-639-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5049 33RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047080",
            "telephone_number": "701-356-1001",
            "fax_number": "701-639-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNEST",
        "first_name": "SHELBY",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-01",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R31203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.