NPIMap

Individual provider Active NPI

Cornell Shelton, MD

  • Physical Medicine & Rehabilitation Physician
  • Fredericksburg, VA
National Provider Identifier
1003807538
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101251254 Issued in VA
Practice address
300 Park Hill Dr
Fredericksburg, VA 22401-3387
Phone
(703) 978-1196
Fax
(703) 978-7762
NPI assigned
Nov 3, 2005
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 80380 MA
Physical Medicine & Rehabilitation Physician 208100000X 0101251254 VA Primary

Addresses

Primary practice location

300 Park Hill Dr
Fredericksburg, VA 22401-3387

Mailing address

6035 Burke Centre Pkwy Ste 390
Burke, VA 22015-3750
Phone (703) 978-1196

Other identifiers 2

IdentifierTypeStateIssuer
3172970MedicaidMA
1003807538MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090105000309 DC Practitioner - Physical Medicine and Rehabilitation 9537156104
I20120320000575 VA Practitioner - Physical Medicine and Rehabilitation 9537156104 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Howard University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8644 Sudley Rd
Suite 115
Manassas, VA 20110-4425
Phone (703) 369-5222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue90
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101251254VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Hospital, Inc. CurrentSince Feb 1, 2018 Accepting new patients
Pathology Associates of Fredericksburg PTR Current Accepting new patients
Stafford Hospital, LLC CurrentSince Feb 1, 2018 Accepting new patients
Mary Washington Healthcare Physicians Current Accepting new patients
Healogics Specialty Physicians of Virginia, LLC CurrentSince Oct 28, 2017 Accepting new patients
Stafford Hospital, LLC CurrentSince Feb 1, 2018 Accepting new patients
Mary Washington Hospital Inc. CurrentSince Feb 1, 2018 Accepting new patients
Centers for Rehabilitation, Pain MGMT, & Wellness Physical Medicine & Rehabilitation Past Accepting new patients
Mwa, PC Past Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients
Innovative Physician Services LLC Physical Medicine & Rehabilitation PastSince Jan 1, 2012 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

10401 Spotsylvania Ave
Ste 201
Fredericksburg, VA 22408
Phone (540) 741-3770

8644 Sudley Rd
Ste 115
Manassas, VA 20110
Phone (703) 369-5222

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

14010 Smoketown Rd
Ste 103
Woodbridge, VA 22192
Phone (571) 402-7322

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1003807538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 BURKE CENTRE PKWY STE 390",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153750",
            "telephone_number": "703-978-1196",
            "fax_number": "703-978-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013387",
            "telephone_number": "703-978-1196",
            "fax_number": "703-978-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "CORNELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "80380",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101251254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172970",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003807538",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.