Active NPI
Clayton Shell
- Clinical Social Worker
- Sanford, FL
National Provider Identifier
1003576174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1483 Travertine Ter
Sanford, FL 32771-7730 - Phone
- (423) 747-7741
- NPI assigned
- Dec 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1483 Travertine Ter
Sanford, FL 32771-7730
Mailing address
1483 Travertine Ter
Sanford, FL 32771-7730
Phone (423) 747-7741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0705 | Other | FL | PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1003576174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1483 TRAVERTINE TER",
"city": "SANFORD",
"state": "FL",
"postal_code": "327717730",
"telephone_number": "423-747-7741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1483 TRAVERTINE TER",
"city": "SANFORD",
"state": "FL",
"postal_code": "327717730",
"telephone_number": "423-747-7741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELL",
"first_name": "CLAYTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-30",
"last_updated": "2021-12-30",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN",
"identifier": "0705",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.