MS. ELIZABETH BERNADETTE SHELLEY (NPI# 1073862207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073862207 |
| Entity Type | Individual |
| Full Name | MS. ELIZABETH BERNADETTE SHELLEY |
| Credential | MSN, FNP, RN |
| Practice Address |
519 W 114th St John Jay Mc 3601 New York NY 10027-7036 |
| Practice Telephone | 2128547426 |
| Practice Fax Number | 2128543372 |
| Mailing Telephone | 2128547426 |
| Mailing Fax Number | 2128543372 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2016-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 652493 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
339329 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04103251 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487031456 | Elizabeth Ann Shelley | Psychiatry & Neurology | 5940 Oak Point Rd, Lorain, OH 44053-4100 | 2015-04-29 |
| 1083056196 | Elizabeth Anne Shelley | Social Worker | 730 Eastern Ave, Malden, MA 02148-5924 | 2013-07-18 |
| 1790061331 | Elizabeth Vance Shelley | Nurse Practitioner | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2011-10-27 |
| Street Address |
519 W 114TH ST JOHN JAY MC 3601 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10027-7036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942307509 | William Richard Glendon Jr. | Family Medicine | 519 W 114th St, John Jay Hall, 4th Floor, New York, NY 10027-7036 | 2006-09-17 |
| 1922396316 | Kathleen Marie Chiu | Nurse Practitioner | 519 W 114th St, Mc3601, New York, NY 10027 | 2011-07-19 |
| 1336456631 | Babie Mar Teleron Regner | Registered Nurse | 519 W 114th St, 3rd Floor John Jay Bldg., New York, NY 10027-7036 | 2010-09-08 |
| 1871809962 | Serena M Baker | Registered Nurse | 519 W 114th St, John Jay Hall, 4th Floor, New York, NY 10027-7036 | 2010-08-26 |
| 1336304237 | Jennifer Lowing | Registered Nurse | 519 W 114th St, John Jay Hall/mc 3601, New York, NY 10027-7036 | 2008-07-21 |
| 1104085679 | Grigoriy Grenader | Family Medicine | 519 W 114th St, John Jay Hall, 3rd Floor, New York, NY 10027-7036 | 2008-06-09 |
| 1174704092 | Christine Contillo | Registered Nurse | 519 W 114th St, Amsterdam Practice Group, New York, NY 10027-7036 | 2007-11-20 |
| 1376758748 | Colleen S Eng | Family Medicine | 519 W 114th St, Columbia Health, John Jay Hall, Mail Code 3601, New York, NY 10027-7036 | 2007-05-11 |
| 1467575498 | Ilene Katz | Registered Nurse | 519 W 114th St, Mc 3601, New York, NY 10027-7036 | 2007-04-06 |
| 1912029794 | Health Services At Columbia | Clinic/Center | 519 W 114th St, Mc 3601, New York, NY 10027-7036 | 2007-04-04 |
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| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1720691199 | Mohamad El Zein | Student in an Organized Health Care Education/Training Program | 281 West 132nd Street, App Nb 2, New York, NY 10027 | 2020-08-26 |
| 1194335893 | Cynthia Wiggins | Social Worker | 1255 Amsterdam Avenue, New York, NY 10027 | 2020-08-06 |
| 1497399877 | Dr. F Sanchez Dental Arts Pllc | Dentist | 2 Saint Nicholas Terrace, Store #1, New York, NY 10027 | 2019-10-29 |
| 1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
| 1396216818 | Gissel Lopez | Licensed Practical Nurse | 119west 124th Street, New York, NY 10027 | 2018-12-10 |
| 1831660620 | Katherine Gonzalez | Licensed Practical Nurse | 119 121 W 124th Street, New York, NY 10027 | 2018-12-06 |
| 1003383456 | Ebony S Prescott | Specialist | 2130 Adam Clayton Powell Blvd, Phenix Salon Suites, Suite #114, Ny, NY 10027 | 2018-10-24 |
| 1619456589 | Arts of Optics Corp. | Optometrist | 200 W 125th St, New York, NY 10027 | 2018-08-10 |
| 1205355658 | Frederick Community Pharmacy Inc | Pharmacy | 2450 Frederick Douglas Blvd, New York, NY 10027 | 2017-09-18 |
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| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
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|---|---|---|---|---|
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| 1770193237 | Lenka Varekova | Nurse Practitioner | 242 E 5th St Apt 3, New York, NY 10003-8501 | 2020-08-08 |
| 1184234817 | Hyun Gyeong Im | Nurse Practitioner | 435 W 46th St Apt 2re, New York, NY 10036-9085 | 2020-08-06 |
| 1942822507 | Busime Mimy Mudekereza | Nurse Practitioner | 1885 Adam Clayton Powell Jr Blvd Apt 2c, New York, NY 10026-2892 | 2020-05-17 |
| 1366061376 | Christine Go Np In Family Health PC | Nurse Practitioner | 315 Madison Ave Ste 1200, New York, NY 10017-5441 | 2020-04-09 |
| 1427687151 | Ken Chuan Michael Chan | Nurse Practitioner | 110 Madison Ave Apt 10, New York, NY 10016-7486 | 2020-04-04 |
| 1528695004 | Marylee Ann Marre | Nurse Practitioner | 226 E 25th St Apt 3d, New York, NY 10010 | 2020-03-25 |
| 1013541275 | Albina Guzman | Nurse Practitioner | 226 5th Ave Fl 6, New York, NY 10001-7706 | 2020-02-26 |
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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.