Shellie Rose Butler, FNP is a medicare enrolled "Nurse Practitioner - Family" in Cumberland Gap, Tennessee. Her current practice location is
779 Highway 63 Ste 1, Cumberland Gap, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 919-9886.
Shellie Rose Butler is licensed to practice in Tennessee (license number 34156) 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 1033898416.
Provider's Profile
| Full Name | Shellie Rose Butler |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 779 Highway 63 Ste 1, Cumberland Gap, Tennessee |
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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: 1033898416
- Provider Enumeration Date: 07/13/2023
- Last Update Date: 05/16/2025
Medicare PECOS Information:
- PECOS PAC ID: 2466813712
- Enrollment ID: I20240118003402
Medical Identifiers
Medical identifiers for Shellie Rose Butler such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033898416 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP2300X | Nurse Practitioner - Primary Care | 34156 (Tennessee) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 34156 (Tennessee) | Primary |
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. Shellie Rose Butler allows following entities to bill medicare on her behalf.
| Entity Name | Kentucky Friendly Care Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467939066
PECOS PAC ID: 0143572909
Enrollment ID: O20190410000910 |
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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. Shellie Rose Butler 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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Shellie Rose Butler, FNP
400 Mountain Lane,
New Tazewell, TN 37825
Ph: (865) 382-0690 | Shellie Rose Butler, FNP
779 Highway 63 Ste 1,
Cumberland Gap, TN 37724-4116
Ph: (423) 919-9886 |
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