Individual provider Active NPI

Kate Shelburne, D.O

  • Pediatrics Physician
  • Glens Falls, NY
National Provider Identifier
1154715720
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
292593 Issued in NY
Practice address
1 Lawrence St
Glens Falls, NY 12801-3617
Phone
(518) 798-9985
NPI assigned
Mar 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 292593 NY Primary

Addresses

Primary practice location

1 Lawrence St
Glens Falls, NY 12801-3617

Mailing address

1 Lawrence St
Glens Falls, NY 12801-3617
Phone (518) 798-9985

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
292593NYMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: kateshelburnedo@gfpeds.medentdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1154715720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAWRENCE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013617",
            "telephone_number": "518-798-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAWRENCE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013617",
            "telephone_number": "518-798-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBURNE",
        "first_name": "KATE",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "292593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.