Shelby Fathauer, FNP-C APRN
Individual provider Active NPI Nurse Practitioner · Thompsons Station, TN
NPI 1982471975 · NPPES record last updated Aug 27, 2026
Key facts
- NPI
- 1982471975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 42195 (TN)
- Practice address
- 2095 Branford PL Ste 102
Thompsons Station, TN 37179-1018 - Phone
- (765) 524-5560
- NPI assigned
- Dec 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- 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 |
|---|---|---|---|---|
| I20240117002019 | IL | Practitioner - Nurse Practitioner | 2264884048 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.496088 | IL | MD | Registered Nurse |
| 209.028790 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current |
Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current |
Accepting new patients | |
| Carle Health Care Incorporated | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- sfathauer334968@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 42195 | TN | Yes |
| Nurse Practitioner | 363L00000X | 209.028790 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209028790 | IL | |
| Registered Nurse | 163W00000X | 041.496088 | IL |
Addresses
Primary practice location
2095 Branford PL Ste 102
Thompsons Station, TN 37179-1018
Mailing address
2095 Branford PL Ste 102
Thompsons Station, TN 37179-1018
Other providers in Thompsons Station, TN
- Lauren Marshall Dutton
- Edward Kenan Enoch
- Alison Patricia Eschrich
- Bradley Matthew Farrow
- Fast Pace Medical Clinic PLLC
- Tricia Camille Faulkner
- Brandi Cirotto Felts
- Ashlee Ferrara
- Marguerite Zayas Fetner
- Holly Frey Fields
All providers in Thompsons Station, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2026. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.