Healthcare Provider Details

I. General information

NPI: 1447387758
Provider Name (Legal Business Name): SHELLY K PAYNTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELLY K SHORT RN

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 34 AND 47
FORT THOMPSON SD
57339-0200
US

IV. Provider business mailing address

210 SCOBY AVENUE PO BOX 509
HIGHMORE SD
57345-0509
US

V. Phone/Fax

Practice location:
  • Phone: 605-245-2285
  • Fax:
Mailing address:
  • Phone: 605-852-2138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR025813
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR025813
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License NumberR025813
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: