Individual provider Active NPI

Rodney Keith Shotton, M.D.

  • Family Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1164443370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11139 Issued in AZ
Practice address
2730 S Val Vista Dr
Suite 187
Gilbert, AZ 85296-6675
Phone
(480) 324-0300
Fax
(480) 324-0324
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11139 AZ Primary

Addresses

Primary practice location

2730 S Val Vista Dr
Suite 187
Gilbert, AZ 85296-6675

Mailing address

2730 S Val Vista Dr
Suite 187
Gilbert, AZ 85296-6675
Phone (480) 324-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060502000553 AZ Practitioner - General Practice 0648280883 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11139AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diamond Diagnostics, LLC CurrentSince Apr 10, 2014 Accepting new patients
Pentz Health Services LLC CurrentSince Mar 15, 2017 Accepting new patients
Infinite Health & Wellness Centers PLLC PastSince Mar 15, 2017 Accepting new patients
Diamond Medical Equipment L.L.C. Past Accepting new patients

Locations

1324 N Farrell Ct
Ste 102
Gilbert, AZ 85233
Phone (480) 926-4363

6402 E Superstition Springs Blvd
Ste 123
Mesa, AZ 85206
Phone (480) 794-1061

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164443370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "address_2": "SUITE 187",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852966675",
            "telephone_number": "480-324-0300",
            "fax_number": "480-324-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "address_2": "SUITE 187",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852966675",
            "telephone_number": "480-324-0300",
            "fax_number": "480-324-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTTON",
        "first_name": "RODNEY",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.