Michael Tyshune Shelton, RN, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F1009375 NP-C Issued in TX

Practice address

829 Goethals Dr
Richland, WA 99352-3529

Phone

(509) 547-2204

Fax

(509) 542-8836

NPI assigned

Aug 25, 2009

Last updated

Nov 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: natalie.badillo.p1@direct.centromed.nextgenshare.com

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.

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  NPD (past)

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1124251103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-922-7000",
            "fax_number": "210-227-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 GOETHALS DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523529",
            "telephone_number": "509-547-2204",
            "fax_number": "509-542-8836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3845 S Padre Island Dr",
            "address_2": "Pediatric Center",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784152919",
            "country_code": "US",
            "telephone_number": "361-854-4626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 N San Saba Ste 1075",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073155",
            "country_code": "US",
            "telephone_number": "210-922-7000",
            "fax_number": "210-227-0282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19005 SE 34th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986831450",
            "country_code": "US",
            "telephone_number": "360-726-6720",
            "fax_number": "360-726-6729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MICHAEL",
        "middle_name": "TYSHUNE",
        "name_prefix": "Mr.",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61096750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61096750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F1009375 NP-C",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "RN 794786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel James Shea, SUDPT
• Marguerite M Shea
• Hannah Sheehan
• Nicole Sheehan, PA-C
• Hannah Amelia Shelton, MN ARNP FNP-C
• Nataliya S Sherepitka, INTERPRETER
• Kelly Sherman, NC
• Kirsten Shockman, PTA
• Allen B Shoham, MD
• Anna K Shoolroy, PA-C

• Family Nurse Practitioner in Richland, WA
• Providers in Richland, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.