Shell Plastic Surgery,PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

20125 Issued in MS

Legal business name

SHELL PLASTIC SURGERY,PLLC

Practice address

1306 Belk Blvd
Oxford, MS 38655-5302

Phone

(901) 682-6828

NPI assigned

May 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dan H Shell IV, M.D.

Title

Physician/Owner

Phone

(901) 682-6828

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leslie Gordon, FNP

  • Nurse Practitioner
  • Oxford, MS
  • NPI 1710633110
  Medicare reassignment NPD
• Daniel Huff Shell IV, MD

  • Plastic Surgery Physician
  • Oxford, MS
  • NPI 1023224250
  Medicare reassignment NPD

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1073770228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555302",
            "telephone_number": "901-682-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELL PLASTIC SURGERY,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2012-11-12",
        "status": "A",
        "authorized_official_last_name": "SHELL",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "901-682-6828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "20125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tacara Shaw, BS
• Bryson Carter Sheffield
• Leslie Dawn Sheffield, FNP-C
• Taylor Shelby, M.ED, NCC
• Elizabeth Grayson Sheley, NP
• Shell Space Counseling, LLC
• Daniel Huff Shell IV, MD
• Tinesha Lynn Shelley, REGISTERED NURSE
• Adeline Meriwether Shelton, RDN, LD
• Matthew H Shelton, M.A. PCMHT

• Plastic and Reconstructive Surgery Physician in Oxford, MS
• Providers in Oxford, MS by specialty
• Plastic and Reconstructive Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.