SHELLEY KELLER CLARK (AG-ACNP) – Acute Care Nurse Practitioner, NPI 1376077636

SHELLEY KELLER CLARK (AG-ACNP) is a healthcare provider. based in Panama city beach, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials AG-ACNP. They hold a License No. ARNP9288435 (FL). The NPI Number for SHELLEY KELLER CLARK (AG-ACNP) is 1376077636

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
SHELLEY KELLER CLARK (AG-ACNP)
NPI
1376077636
Phone
(850) 294-1282
Address
8510 N LAGOON DR
Enumeration Date
13 April 2017
Last Update Date
27 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8502153062207
Graduation Year
2016 (10 years ago)
PAC ID
6103186358
Group Practice PAC ID
9335379429
Professional Enrollment ID
I20180207002174
Address ID
FL324052226PA2232XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:9State licenses:1Digital endpointsOther names

24,243 NURSE PRACTITIONER in FL

Provider Addresses for SHELLEY KELLER CLARK (AG-ACNP)

  • 8510 N LAGOON DR

    PANAMA CITY BEACH, FL 324084518

    Phone: (850) 294-1282

    Type: Mailing

  • 615 N BONITA AVE

    PANAMA CITY, FL 324013623

    Phone: (850) 294-1282

    Type: Location

  • 708 BREAKFAST POINT BLVD

    PANAMA CITY BEACH, FL 324072534

    Phone: (850) 294-1282

    Type: Mailing

  • 2232 W 24TH ST

    PANAMA CITY, FL 324052226

    Phone: (850) 215-3024

    Type: Location

  • 449 W 23rd St

    Panama City, FL 324054507

    Phone: (850) 769-8341

    Type: Location

  • 286, Forest Park Circle, Panama City, Bay County, Florida, 32405, United States

    PANAMA CITY, FL 324054921

    Phone: (850) 640-0663

    Fax: (850) 215-7096

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 94 Open Payments records for all available years, with a total value of $2,205.

Total Amount is formed as General ($2,205) + Research ($0) + Ownership ($0) = $2,205.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($379).

Total Amount

$2,205

General + Research + Ownership

Payments

94

Total payment records

General Amount

$2,205

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-02-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180207002174INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes1,904399$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes296174$0
99239Hospital discharge day management, more than 30 minutes139136$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes107105$0
99238Hospital discharge day management, 30 minutes or less9999$0
View full utilization report →

Insurance plans in this area (ZIP 32408)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335379429View full group profile
NameSpecialtyState
Nurse PractitionerFL
R H E U M A T O L O G YFL
-FL

Reviews

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Frequently asked questions

How is SHELLEY KELLER CLARK (AG-ACNP) identified in CMS data?
CMS-hosted NPPES data lists SHELLEY KELLER CLARK (AG-ACNP) with NPI 1376077636.
Is SHELLEY KELLER CLARK (AG-ACNP) listed as active for patients and plans?
The listing shows SHELLEY KELLER CLARK (AG-ACNP) as active in the NPI system.
What is SHELLEY KELLER CLARK (AG-ACNP) best known for clinically?
Directory data describes SHELLEY KELLER CLARK (AG-ACNP) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does SHELLEY KELLER CLARK (AG-ACNP) serve?
SHELLEY KELLER CLARK (AG-ACNP)'s listing highlights Panama City Beach, Florida; more addresses can appear in NPPES.
Why does SHELLEY KELLER CLARK (AG-ACNP) have multiple addresses?
7 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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