Individual provider Active NPI

John Buford Shelton, MD

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1083688964
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K5688 Issued in TX
Practice address
6101 Woodway Dr Ste 200
Waco, TX 76712-6117
Phone
(254) 537-6300
Fax
(254) 537-6301
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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 K5688 TX Primary

Addresses

Primary practice location

6101 Woodway Dr Ste 200
Waco, TX 76712-6117

Mailing address

PO Box 18962
Belfast, ME 04915-4084
Phone (800) 566-5050

Other identifiers 3

IdentifierTypeStateIssuer
84597XOtherTXBCBS
122149104MedicaidTX
00N59XOtherTXBCBS

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
I20100212000483 TX Practitioner - Family Practice 0446394571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

6101 Woodway Dr
200 Providence Family Health Clinic
Waco, TX 76712-6117
Phone (254) 537-6300

Hospital & facility affiliations

  • Ascension Providence Hospital, Waco, TX, CCN 450042
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Oct 1, 2010 Accepting new patients
Providence Health Alliance CurrentSince Oct 1, 2010 Accepting new patients
Mickey P. Sharma, M.D. Past Accepting new patients

Locations

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

6101 Woodway Dr
Ste 200
Woodway, TX 76712
Phone (254) 537-6300

Interoperability endpoints

  • Direct secure messaging: john.shelton.1@9635.direct.athenahealth.com

Organizations & group practices 3

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1083688964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18962",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "800-566-5050",
            "fax_number": "254-537-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 WOODWAY DR STE 200",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126117",
            "telephone_number": "254-537-6300",
            "fax_number": "254-537-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JOHN",
        "middle_name": "BUFORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84597X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122149104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00N59X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.