SHELLY PRATHER (FNP) – Family Nurse Practitioner, NPI 1124657887

SHELLY PRATHER (FNP) is a healthcare provider. based in Lebanon, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 202006753NP-PP (OR). The NPI Number for SHELLY PRATHER (FNP) is 1124657887

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
SHELLY PRATHER (FNP)
NPI
1124657887
Phone
(458) 223-0848
Address
350 WHEELER ST
Enumeration Date
5 April 2020
Last Update Date
15 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5412675151
Graduation Year
2020 (6 years ago)
PAC ID
5092125732
Group Practice PAC ID
5597677716
Professional Enrollment ID
I20201106002472
Address ID
OR974202045CO1900XDRXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for SHELLY PRATHER (FNP)

  • 350 WHEELER ST

    LEBANON, OR 973554349

    Phone: (458) 223-0848

    Type: Mailing

  • 1900 WOODLAND DR

    COOS BAY, OR 974202099

    Phone: (541) 267-5151

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2024-02-21 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($125).

Total Amount

$125

General + Research + Ownership

Payments

1

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-21

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: 2020-11-06

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
I20201106002472INurse PractitionerORTBD

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
81003Automated urinalysis test2315$0
View full utilization report →

Insurance plans in this area (ZIP 97355)

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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: 5597677716View full group profile

Reviews

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Frequently asked questions

Can I cross-check SHELLY PRATHER (FNP) using NPI 1124657887?
NPI 1124657887 belongs to SHELLY PRATHER (FNP); compare other details if you need extra assurance.
Is there an active status for SHELLY PRATHER (FNP)?
For scheduling context, SHELLY PRATHER (FNP) is shown as active in the registry.
What clinical focus is listed for SHELLY PRATHER (FNP)?
At a glance, SHELLY PRATHER (FNP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with SHELLY PRATHER (FNP)?
Directory geography for SHELLY PRATHER (FNP) centers on Lebanon, Oregon.
Does SHELLY PRATHER (FNP) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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