Individual provider Active NPI

Lori Sumerford Shelton, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1164518254
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002308 Issued in VA
Practice address
2088 Princess Anne Rd
Virginia Beach, VA 23456-4014
Phone
(757) 668-6700
Fax
(757) 668-6680
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002308 VA
Surgical Physician Assistant 363AS0400X 0110002308 VA
Physician Assistant 363A00000X 0110002308 VA Primary
Physician Assistant 363A00000X 1813 TN

Addresses

Primary practice location

2088 Princess Anne Rd
Virginia Beach, VA 23456-4014

Mailing address

2088 Princess Anne Rd
Virginia Beach, VA 23456-4014
Phone (757) 668-6700

Other practice location 1

2021 Concert Dr Ste 201
Virginia Beach, VA 23456-8083
Phone (757) 668-6700

Other identifiers 1

IdentifierTypeStateIssuer
1164518254MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20070329000614 VA Practitioner - Physician Assistant 0749384865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002308VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Medical Group Inc CurrentSince Sep 21, 2025 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Dec 1, 2016 Accepting new patients
Medical Observation Services LLC Past Accepting new patients
Cumberland Family Care, P.C. Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Volunteer Medical Group, P.C. Past Accepting new patients

Locations

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

2021 Concert Dr
Ste 201
Virginia Beach, VA 23456
Phone (757) 668-6700

Organizations & group practices 10

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1164518254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564014",
            "telephone_number": "757-668-6700",
            "fax_number": "757-668-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564014",
            "telephone_number": "757-668-6700",
            "fax_number": "757-668-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Concert Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568083",
            "country_code": "US",
            "telephone_number": "757-668-6700",
            "fax_number": "757-668-2855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "LORI",
        "middle_name": "SUMERFORD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002308",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002308",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002308",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164518254",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.