Individual provider Active NPI

Virginia L Shelton, FNP

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1104811652
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
810668 Issued in MS
Practice address
1509 Dulles Dr
Lafayette, LA 70506-3718
Phone
(337) 408-0797
Fax
(337) 943-0846
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5785 TN
Family Nurse Practitioner 363LF0000X 810668 MS Primary

Addresses

Primary practice location

1509 Dulles Dr
Lafayette, LA 70506-3718

Mailing address

1509 Dulles Dr
Lafayette, LA 70506-3718
Phone (337) 408-0797

Other identifiers 2

IdentifierTypeStateIssuer
00122700MedicaidMS
3342891MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709002526 MS Practitioner - Nurse Practitioner 9739272873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5785TNMDOccupational Therapist
810668MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Tennessee LLC Nurse Practitioner CurrentSince Aug 1, 2015 Accepting new patients
Curana Health of Mississippi LLC Family CurrentSince Aug 1, 2015 Accepting new patients

Locations

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

955 N Germantown Pkwy
Cordova, TN 38018
Phone (901) 754-1393

5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295

9155 Crestwyn Hills Dr
Memphis, TN 38125
Phone (901) 261-4848

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1104811652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-408-0797",
            "fax_number": "337-943-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-408-0797",
            "fax_number": "337-943-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "VIRGINIA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "5785",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "810668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122700",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3342891",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.