Individual provider Active NPI

Kelly F Shedd, MD

  • Specialist
  • Gastonia, NC
National Provider Identifier
1104836048
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
38951 Issued in KY
Practice address
2391 Court Dr Ste 110
Gastonia, NC 28054-2197
Phone
(704) 866-0101
Fax
(704) 866-0103
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 38951 KY Primary

Addresses

Primary practice location

2391 Court Dr Ste 110
Gastonia, NC 28054-2197

Mailing address

2391 Court Dr Ste 110
Gastonia, NC 28054-2197
Phone (704) 866-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130823000830 NC Practitioner - Internal Medicine 5193768109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kentucky College of Medicine, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Internal Medicine Associates of Gastonia PAGroup PAC ID 3274427257, 3 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2391 Court Dr
Suite 110
Gastonia, NC 28054-2197
Phone (704) 853-3330

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Gastonia, NC, CCN 347131
  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38951KYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Gastonia PA CurrentSince Jul 8, 2013 Accepting new patients
Hospital Internal Medicine PA Specialist Past Accepting new patients

Locations

2391 Court Dr
Ste 110
Gastonia, NC 28054
Phone (704) 853-3330

Interoperability endpoints

  • Direct secure messaging: kellyshedd@intmedasso.allscriptsdirect.net

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1104836048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2391 COURT DR STE 110",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542197",
            "telephone_number": "704-866-0101",
            "fax_number": "704-866-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 COURT DR STE 110",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542197",
            "telephone_number": "704-866-0101",
            "fax_number": "704-866-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "KELLY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "38951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.