Active NPI
Angela Reese Shelton, D.M.D.
- Dentist
- Radcliff, KY
National Provider Identifier
1114349479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7521
- Practice address
- 299 W Lincoln Trail Blvd Ste 102
Radcliff, KY 40160-3306 - Phone
- (270) 352-5566
- Fax
- (270) 352-5602
- NPI assigned
- Jan 6, 2014
- Last updated
- Jan 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7521 | KY | Primary |
Addresses
Primary practice location
299 W Lincoln Trail Blvd Ste 102
Radcliff, KY 40160-3306
Mailing address
PO Box 778
Radcliff, KY 40159-0778
Phone (270) 352-5566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7521 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvey and Nichols Radcliff PLLC | Past | Accepting new patients | |
| Angela R Shelton DMD PSC | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Harvey and Nichols Radcliff
- Clinic/Center
- Radcliff, KY
- NPI 1295521540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388966400000",
"number": "1114349479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 778",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401590778",
"telephone_number": "270-352-5566",
"fax_number": "270-352-5602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 W LINCOLN TRAIL BLVD STE 102",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401603306",
"telephone_number": "270-352-5566",
"fax_number": "270-352-5602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "ANGELA",
"middle_name": "REESE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-06",
"last_updated": "2014-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Radcliff, KY
- Senior Health Services LLC
- Abbye Elizabeth Senn, PT
- Serenity Counseling, LLC
- Juxhin Shabani, PHARM.D
- Kayla Shafer, BCABA
- Brooke Elizabeth Shelton, DMD
- Stephen Shepherd, PT, DPT
- Shiloh City of Peace Foundation Inc (Guardianship Services of Kentucky)
- Dawnita Michell Shively, BCBA
- Show-N-Tell Beauty & Suite Salon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.