Amanda L Shelby, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9210 Issued in CT

Practice address

915 Poquonnock Rd
Groton, CT 06340-4257

Phone

(860) 446-0144

NPI assigned

Oct 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.shelby.npi1982204715.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment Care Compare group NPD
• Lswhb LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Milford, OH
  • NPI 1407325939
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
  • NPI 1073529566
  Care Compare affiliation

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1982204715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OLD KENT RD N",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404257",
            "telephone_number": "860-446-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "137290",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2309851",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Meagan Shaw
• Cody Eugene Shaw
• Taylor R Shaw
• Georgette Nicole Shea, NP
• Kris L Shea, PSYD
• Leila M. Shepard, LPC
• Sheridan Healthcare of Connecticut, PC
• Nadia Shipper, DC
• Shoreline Counseling Associates, LLC
• Shoreline Counseling Group,LLC

• Family Nurse Practitioner in Groton, CT
• Providers in Groton, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.