SHELLEY NICOLE GOUGH (NP-C) – Family Nurse Practitioner, NPI 1164019501
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,192 NURSE PRACTITIONER in IN
Provider Addresses for SHELLEY NICOLE GOUGH (NP-C)
PO BOX 485
NEW CASTLE, IN 473620485
Phone: (765) 521-1516
Type: Mailing
2200 FOREST RIDGE PKWY STE 310
NEW CASTLE, IN 473622943
Phone: (765) 599-3400
Type: Location
4120 N 600 W
FARMLAND, IN 473409259
Phone: (765) 748-5498
Type: Mailing
152 Wittenbraker Ave
New Castle, IN 473625000
Phone: (765) 599-3100
Type: Location
3512 Stellhorn Rd
Fort Wayne, IN 468154631
Phone: (260) 483-9081
Type: Location
3512 STELLHORN RD
FORT WAYNE, IN 468154631
Phone: (260) 483-9081
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $975.
Total Amount is formed as General ($975) + Research ($0) + Ownership ($0) = $975.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: ABBVIE INC. ($231).
Total Amount
$975
General + Research + Ownership
Payments
59
Total payment records
General Amount
$975
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $231 |
| Lilly USA, LLC | $142 |
| Novo Nordisk Inc | $99 |
| Lundbeck LLC | $52 |
| PFIZER INC. | $45 |
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: 2021-01-29
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 |
|---|---|---|---|---|
| I20210129001643 | I | Nurse Practitioner | IN | 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 47362)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Diagnostic Radiology | IN | |
| Nurse Practitioner | IN | |
| Internal Medicine | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN | |
| P S Y C H I A T R Y | IN | |
| Family Practice | IN |
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