Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Shelby Rigdon Tieken, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1255924064

Mr. Shelby Rigdon Tieken, AGACNP-BC is a Nurse Practitioner in Fort Worth, Texas. Qualified in 2020, 6 years ago. Practices with Acclaim Physician Group Inc, a 523-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2021
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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1901 N Macarthur Blvd, Irving, TX 75061-2220 — (972) 579-8100

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1028643 (TX)

Record details

NPI number1255924064
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedFebruary 12, 2021
Last updated in NPPESJanuary 10, 2024
Certification dateJanuary 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Acclaim Physician Group Inc — 523 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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