SHELLY CHURCHILL – Nurse Practitioner, NPI 1720731813
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for SHELLY CHURCHILL
14690 SPRING HILL DR STE 305
SPRING HILL, FL 346098102
Phone: (352) 277-5348
Fax: (352) 606-2857
Type: Mailing
13235 STATE ROAD 52 STE 102
HUDSON, FL 346692968
Phone: (727) 378-8503
Fax: (727) 857-7807
Type: Location
PO BOX 198441
ATLANTA, GA 303848441
Phone: (813) 745-4673
Fax: (813) 449-8618
Type: Mailing
12902 USF MAGNOLIA DR
TAMPA, FL 336129416
Phone: (813) 745-4673
Fax: (813) 745-3540
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $1,836.
Total Amount is formed as General ($1,836) + Research ($0) + Ownership ($0) = $1,836.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($238).
Total Amount
$1,836
General + Research + Ownership
Payments
28
Total payment records
General Amount
$1,836
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2022-02-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220203000425 | I | Nurse Practitioner | FL | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 34609)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| H E M A T O L O G Y/ O N C O L O G Y | GA | |
| - | FL | |
| - | FL | |
| H E M A T O L O G Y/ O N C O L O G Y | OH | |
| - | FL |
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