Shelby Leeann Sheider, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

86491 Issued in GA

Practice address

1650 Cochrane Cir # B7500
Fort Carson, CO 80913-4613

Phone

(762) 408-2655

NPI assigned

Jun 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Leeann Wentworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1164081766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR # B7500",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "762-408-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR # B7500",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "762-408-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEIDER",
        "first_name": "SHELBY",
        "middle_name": "LEEANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "86491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "WENTWORTH",
            "middle_name": "LEEANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khalid Benwalid Shafie, DDS
• Christine Ruby Shannon, RN
• Kareen Shaw, DO
• Tamara Shaw, LCSW
• Jennifer Lind Shawver, PHARMD
• Robin L. Shelton, RN, PHN
• Vishwa Sheoran
• Melissa Shepherd, FNP-BC
• Cynthia Franklin Sheridan, CRNA
• Samantha Ruth Shipley, DDS

• Family Medicine Physician in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Family Medicine Physician in Colorado

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