Active NPI
James Mason Shelley Jr., M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Springfield, MO
National Provider Identifier
1043389760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 107697
- Practice address
- 1000 E Primrose St Ste 550
Springfield, MO 65807-5180 - Phone
- (417) 269-4647
- Fax
- (417) 269-8078
- NPI assigned
- Nov 7, 2006
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 107697 | MO | Primary |
Addresses
Primary practice location
1000 E Primrose St Ste 550
Springfield, MO 65807-5180
Mailing address
1000 E Primrose St Ste 300
Springfield, MO 65807-5178
Phone (417) 269-4646
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159012 | Other | MO | BLUECROSS BLUESHIELD |
| 421539307 | Other | MO | FED TAX ID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Services of Springfield, P.C. | Past | Accepting new patients |
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.
-
- Clinical Medical Laboratory
- Springfield, MO
- NPI 1801935879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1043389760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E PRIMROSE ST STE 300",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075178",
"telephone_number": "417-269-4646",
"fax_number": "417-269-8078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E PRIMROSE ST STE 550",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075180",
"telephone_number": "417-269-4647",
"fax_number": "417-269-8078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEY",
"first_name": "JAMES",
"middle_name": "MASON",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MO",
"license": "107697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "159012",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "421539307",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.