NICHOLAS SHELLEY (NPI# 1215410220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215410220 |
| Entity Type | Individual |
| Full Name | NICHOLAS SHELLEY |
| Credential | NP |
| Practice Address |
12700 Creekside Ln Fort Myers FL 33919-3356 |
| Practice Telephone | 2392924822 |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2019-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WG0000X |
Registered Nurse Specialization: General Practice |
9446478 | FL | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 9666478 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5352 Shalley Cir W, Fort Myers, FL 339192208 | 2392924822 |
| Street Address |
12700 CREEKSIDE LN |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33919-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241254 | Athanassios Drimoussis | Internal Medicine | 12700 Creekside Ln, Ste 201, Fort Myers, FL 33919-3356 | 2005-08-02 |
| 1881025203 | Dorothea Ann Tocco | Physician Assistant | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2013-12-11 |
| 1619310091 | Kathleen Bell | Nurse Practitioner | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2013-04-16 |
| 1760726061 | Jacquelynn Marie Kubay | Nurse Practitioner | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2012-11-27 |
| 1053694877 | Ross W Kravetz | Physician Assistant | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2011-09-28 |
| 1144415571 | Robert A Goldman | Physical Therapist | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2007-09-10 |
| 1740358928 | Elaine Joy Arpin | Neurological Surgery | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2006-12-04 |
| 1730256934 | George W Sypert | Neurological Surgery | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2006-11-30 |
| 1578642336 | Gretchen Nelson | Physician Assistant | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2006-11-03 |
| 1801859202 | Douglas F. Savage | Neurological Surgery | 12700 Creekside Ln, Suite 101, Fort Myers, FL 33919-3356 | 2006-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145942 | Patricia June Briand | Registered Nurse | 4309 Mariner Way #307, Fort Myers, FL 33919 | 2020-02-10 |
| 1629556840 | The Onyx Counseling Center, LLC | Social Worker | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919 | 2018-07-31 |
| 1366980187 | My Precious Kids Therapy Center Inc | Community/Behavioral Health | 4755 Summerlin Road, Suite #4, Fort Myers, FL 33919 | 2017-02-01 |
| 1811342397 | Kimberly Regenesis | Substance Abuse Rehabilitation Facility | 8695 College Parkway, Suite 2080, Ft Myers, FL 33919 | 2016-05-03 |
| 1689030207 | Balance for All, Inc. | Acupuncturist | 6238 Presidential Ct., Ste 6, Fort Myers, FL 33919 | 2016-01-12 |
| 1902275217 | Kelly Jean Overton | Physical Therapist | 6341 Whiskey Creek Drive, Fort Myers, FL 33919 | 2015-09-16 |
| 1508125311 | Charles Clark Dugan IIi | Chiropractor | 6309 Corporate Court, Suite 110, Fort Myers, FL 33919 | 2012-05-14 |
| 1659641231 | Dasha Bich Le | Pharmacist | 9629 Bay Harbor Cir., Apt. 201, Fort Myers, FL 33919 | 2012-01-12 |
| 1164792602 | Gail Lee Rathbun | Nurse Practitioner | 6311 S. Pointe Blvd., Fort Meyers, FL 33919 | 2011-12-30 |
| 1871878173 | Scott Kozlowski | Behavioral Analyst | 5335 Shalley Cir., Ft. Myers, FL 33919 | 2011-10-18 |
| Find all providers in zip 33919 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093330714 | Renuka Jackson | Nurse Practitioner | 6150 Diamond Centre Ct Unit 100, Fort Myers, FL 33912-4367 | 2020-06-09 |
| 1386101798 | Debra Lee Sicilian | Nurse Practitioner | 2327 Jeffcott St, Fort Myers, FL 33901-5211 | 2019-02-22 |
| 1619452877 | Kamila Shurii Tursi | Nurse Practitioner | 6631 Orion Dr Ste 110, Fort Myers, FL 33912-4333 | 2018-10-03 |
| 1003396714 | Carmalee Martin | Nurse Practitioner | 9341 Via San Giovani St, Fort Myers, FL 33905-5564 | 2018-08-21 |
| 1740779701 | Dedra Dawn Coop | Nurse Practitioner | 13300 S Cleveland Ave Ste 56, Fort Myers, FL 33907-3871 | 2018-05-05 |
| 1073039087 | Ruth Milien Jonathas | Nurse Practitioner | 16420 Healthpark Commons Dr Ste 100, Fort Myers, FL 33908-9621 | 2017-08-21 |
| 1396283578 | Jerry Hernandez Sr. | Nurse Practitioner | 12731 World Plaza Ln Bldg 83, Fort Myers, FL 33907-4081 | 2017-02-07 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| 1942752134 | Lauren Chandler Masters | Nurse Practitioner | 14300 Riva Del Lago Dr Apt 704, Fort Myers, FL 33907-7804 | 2016-11-04 |
| 1467706192 | Kerry Spillane | Nurse Practitioner | 9981 S. Healthpark Dr, Fort Myers, FL 33908-3618 | 2012-11-02 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33919 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.