Mrs Mary C Shellnutt, APRN, AGCNS-BC is a medicare enrolled "Clinical Nurse Specialist" in Tyler, Texas. Her current practice location is
501 Saunders Ave Ste 320, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at
(903) 606-5140.
Mrs Mary C Shellnutt is licensed to practice in Texas (license number AP128617) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811366552.
Provider's Profile
| Full Name | Mrs Mary C Shellnutt |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist |
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| Location | 501 Saunders Ave Ste 320, Tyler, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811366552
- Provider Enumeration Date: 09/23/2015
- Last Update Date: 03/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 8729439831
- Enrollment ID: I20240112001015
Medical Identifiers
Medical identifiers for Mrs Mary C Shellnutt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811366552 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SA2200X | Clinical Nurse Specialist - Adult Health | AP128617 (Texas) | Secondary |
| 364S00000X | Clinical Nurse Specialist | AP128617 (Texas) | Primary |
| 364SG0600X | Clinical Nurse Specialist - Gerontology | AP128617 (Texas) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Mary C Shellnutt allows following entities to bill medicare on her behalf.
| Entity Name | Christus Trinity Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Mary C Shellnutt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Mary C Shellnutt, APRN, AGCNS-BC
501 Saunders Ave Ste 320,
Tyler, TX 75702-7524
Ph: (469) 247-2365 | Mrs Mary C Shellnutt, APRN, AGCNS-BC
501 Saunders Ave Ste 320,
Tyler, TX 75702-7524
Ph: (903) 606-5140 |
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