JERRY SHELBY (NP) – Nurse Practitioner, NPI 1194355685

JERRY SHELBY (NP) is a healthcare provider. based in Joliet, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209020743 (IL). The NPI Number for JERRY SHELBY (NP) is 1194355685

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JERRY SHELBY (NP)
NPI
1194355685
Phone
(815) 740-1900
Address
301 MADISON ST
Enumeration Date
23 January 2020
Last Update Date
1 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6309786200
Graduation Year
2019 (7 years ago)
PAC ID
6002247749
Group Practice PAC ID
1850657180
Professional Enrollment ID
I20200512003071
Address ID
IL605047222AU2000XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for JERRY SHELBY (NP)

  • 301 MADISON ST

    JOLIET, IL 604356549

    Phone: (815) 740-1900

    Type: Location

  • 1860 PAYSPHERE CIR

    CHICAGO, IL 606740018

    Phone: (630) 469-9200

    Type: Mailing

  • 24047 W LOCKPORT ST

    PLAINFIELD, IL 605442205

    Phone: (815) 201-0573

    Fax: (815) 513-6178

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2020-05-12

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
I20200512003071INurse PractitionerILTBD

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
99284Emergency department visit with moderate level of medical decision making5352$0
99285Emergency department visit with high level of medical decision making4948$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only3029$0
View full utilization report →

Insurance plans in this area (ZIP 60435)

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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: 1850657180View full group profile
NameSpecialtyState
Emergency MedicineIL
Emergency MedicinePA
-IL
Emergency MedicineIL
Emergency MedicineIL
Emergency Medicine, Internal MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is the registry number for JERRY SHELBY (NP)?
The registry entry for JERRY SHELBY (NP) shows NPI 1194355685.
Should I treat JERRY SHELBY (NP) as an active provider?
Patients and plans typically see JERRY SHELBY (NP) as active in the national extract.
What type of care does JERRY SHELBY (NP) provide?
JERRY SHELBY (NP)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is JERRY SHELBY (NP) tied to Joliet, Illinois?
If you are local to Joliet, Illinois, JERRY SHELBY (NP) may be relevant to your search.
Who maintains JERRY SHELBY (NP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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