A Teresa Gabiola Shelton, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-1091 Issued in ID

Practice address

6051 W Emerald St
Boise, ID 83704-8969

Phone

(208) 302-5150

Fax

(208) 302-5155

NPI assigned

Sep 13, 2011

Last updated

Dec 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Physician Assistant

State licenses

Practice roles

Locations

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.

• Saint Alphonsus Medical Center- Ontario Inc

  • Internal Medicine Physician
  • Ontario, OR
  • NPI 1093034159

  ID

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  NPD
• Saint Alphonsus Medical Center- Ontario Inc

  dba Saint Alphonsus Medical Center Ontario

  • General Acute Care Hospital
  • Ontario, OR
  • NPI 1891891792
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1134401326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-8550",
            "fax_number": "208-367-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABIOLA SHELTON",
        "first_name": "A TERESA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8075898-1206",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Kae Furniss, LMSW
• Lindsay M Fustos, LMSW
• Future Public School, Inc.
• Vedaliah Fye
• Courtney Gabbert
• Jacob A Gabrielsen, DPT
• Cristina Gabutti
• Mindy B. Gaddis, MD
• Aimee Edwards Gaedecke, MA, LPC
• Michaela Gaffney, LCSW

• Medical Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.