Individual provider Active NPI

Alison Amalia Shelton, FNP-BC

  • Family Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1114492386
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8833 Issued in WI
Practice address
3710 57TH Ave
Kenosha, WI 53144-4820
Phone
(866) 389-2727
NPI assigned
Oct 3, 2018
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8833 WI Primary
Family Nurse Practitioner 363LF0000X 209021206 IL

Addresses

Primary practice location

3710 57TH Ave
Kenosha, WI 53144-4820

Mailing address

3710 57TH Ave
Kenosha, WI 53144-4820
Phone (866) 389-2727

Other practice location 1

11200 Lincoln Hwy
Mokena, IL 60448-8208
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190219001302 WI Practitioner - Nurse Practitioner 7618215567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Wisconsin LLCGroup PAC ID 7810210259, 9 clinicians

Practice addresses (Care Compare)

1650 N Farwell Ave
Milwaukee, WI 53202-2331
Phone (866) 389-2727

3710 57TH Ave
Kenosha, WI 53144-4820
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209021206ILMDFamily Nurse Practitioner
8833WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Wisconsin, LLC Family CurrentSince Mar 22, 2019 Accepting new patients

Locations

3710 57th Ave
Kenosha, WI 53144
Phone (262) 652-1474

1650 N Farwell Ave
Milwaukee, WI 53202
Phone (414) 277-5044

8661 N Port Washington Rd
Milwaukee, WI 53217
Phone (414) 540-6836

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1114492386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 57TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444820",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 57TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444820",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 Lincoln Hwy",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488208",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "ALISON",
        "middle_name": "AMALIA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8833",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.