NPIMap

Individual provider Active NPI

Jonathan Richard Shelton, PA

  • Physician Assistant
  • Marion, VA
National Provider Identifier
1063859544
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004242 Issued in VA
Practice address
245 Medical Park Dr Ste B
Marion, VA 24354-1100
Phone
(276) 378-1000
NPI assigned
May 24, 2013
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110004242 VA Primary

Addresses

Primary practice location

245 Medical Park Dr Ste B
Marion, VA 24354-1100

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000

Other practice location 2

1787 W Lee Hwy
Wytheville, VA 24382-1437
Phone (276) 227-0967

Other practice location 3

58 Carroll Street
Lebanon, VA 24266-4510
Phone (276) 883-8000

Other identifiers 1

IdentifierTypeStateIssuer
1063859544MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130905000002 VA Practitioner - Physician Assistant 4880837194 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Pain Center of the Blue RidgeGroup PAC ID 4486876703, 7 clinicians
Murray E Joiner Jr MD PCGroup PAC ID 4284637695, 17 clinicians

Practice addresses (Care Compare)

1040 Holston Rd
Wytheville, VA 24382-4107
Phone (276) 335-1290

1945 Thomson Dr
Lynchburg, VA 24501-1025
Phone (434) 845-6664

2726 Electric Rd
Suite 203
Roanoke, VA 24018-3528
Phone (540) 772-4448

961 E Stuart Dr
Galax, VA 24333-2407
Phone (276) 238-0439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3096TNMDGeneral Practice Dentistry
0110004242VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Twin County Physician Practices LLC CurrentSince Aug 1, 2024 Accepting new patients
DLP Twin County Physician Practices LLC CurrentSince Aug 1, 2024 Accepting new patients
Murray E Joiner Jr MD PC Physician Assistant CurrentSince Oct 5, 2017 Accepting new patients
Skyline Health Current Accepting new patients
Murray E Joiner Jr MD PC CurrentSince Oct 5, 2017 Accepting new patients
DLP Twin County Physician Practices LLC Past Accepting new patients

Locations

961 E Stuart Dr
Galax, VA 24333
Phone (276) 236-3931

1945 Thomson Dr
Lynchburg, VA 24501
Phone (434) 845-6664

2726 Electric Rd
Ste 203
Roanoke, VA 24018
Phone (540) 772-4448

Interoperability endpoints

  • Direct secure messaging: jonathan.shelton.1@10112.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 9

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1063859544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MEDICAL PARK DR STE B",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243541100",
            "telephone_number": "276-378-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16000 Johnston Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1787 W Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Wytheville",
            "state": "VA",
            "postal_code": "243821437",
            "country_code": "US",
            "telephone_number": "276-227-0967",
            "fax_number": "276-227-0956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Carroll Street",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242664510",
            "country_code": "US",
            "telephone_number": "276-883-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063859544",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

Verify at the official NPI Registry.