Individual provider Active NPI

Khadija Jones-Shelton, DO

  • Family Medicine Physician
  • Savannah, GA
National Provider Identifier
1023748696
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
109401 Issued in GA
Practice address
527 Eisenhower Dr
Savannah, GA 31406-2668
Phone
(912) 819-9100
Fax
(912) 819-9101
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 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 109401 GA Primary

Addresses

Primary practice location

527 Eisenhower Dr
Savannah, GA 31406-2668

Mailing address

527 Eisenhower Dr
Savannah, GA 31406-2668
Phone (912) 819-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260107000614 GA Practitioner - Family Practice 4789064676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

527 Eisenhower Dr
Savannah, GA 31406-2668
Phone (912) 819-9100

Hospital & facility affiliations

  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
  • Candler Hospital Hospital, Savannah, GA, CCN 110024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109401GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc Family Medicine CurrentSince Nov 1, 2025 Accepting new patients

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

527 Eisenhower Dr
Savannah, GA 31406
Phone (912) 443-4200

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 2

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1023748696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062668",
            "telephone_number": "912-819-9100",
            "fax_number": "912-819-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062668",
            "telephone_number": "912-819-9100",
            "fax_number": "912-819-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES-SHELTON",
        "first_name": "KHADIJA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "109401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.