Individual provider Active NPI

Michael Vise Shelton, M.D.

  • Family Medicine Physician
  • Odessa, TX
National Provider Identifier
1003810995
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E8905 Issued in TX
Practice address
4222 Wendover Ave
Ste 600
Odessa, TX 79762-5983
Phone
(432) 552-5656
Fax
(432) 552-0992
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E8905 TX Primary

Addresses

Primary practice location

4222 Wendover Ave
Ste 600
Odessa, TX 79762-5983

Mailing address

4222 Wendover Ave Ste 600
Odessa, TX 79762-5983
Phone (432) 552-5656

Other identifiers 2

IdentifierTypeStateIssuer
133690105MedicaidTX
89030XOtherTXBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902001167 TX Practitioner - Family Practice 3678508090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Physicians, PLLCGroup PAC ID 7214963958, 16 clinicians

Practice addresses (Care Compare)

4222 Wendover Ave
Suite 600
Odessa, TX 79762-5983
Phone (432) 522-5656

Hospital & facility affiliations

  • Express Nursing Home health agency, Odessa, TX, CCN 679327
  • Angels Care Home Health Home health agency, Midland, TX, CCN 677864
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132
  • Odessa Regional Medical Center Hospital, Odessa, TX, CCN 450661
  • Midland Memorial Hospital Hospital, Midland, TX, CCN 450133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E8905TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First Physicians, PLLC Family Medicine CurrentSince Aug 16, 1999 Accepting new patients

Locations

4222 Wendover Ave
Ste 600
Odessa, TX 79762
Phone (432) 522-5656

3051 E University Blvd
Odessa, TX 79762
Phone (432) 362-4376

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10019/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.shelton.1@10019.direct.athenahealth.com

Organizations & group practices 1

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

Hospital & facility affiliations 6

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1003810995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 WENDOVER AVE STE 600",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625983",
            "telephone_number": "432-552-5656",
            "fax_number": "432-552-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 WENDOVER AVE",
            "address_2": "STE 600",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625983",
            "telephone_number": "432-552-5656",
            "fax_number": "432-552-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MICHAEL",
        "middle_name": "VISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E8905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133690105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "89030X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.