Thomas M. Shelburne, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23771 Issued in NC

Practice address

4000 S Swaim Street Ext
Jonesville, NC 28642-9418

Phone

(336) 835-6300

Fax

(336) 835-4761

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Duke University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshelburne2754255@carolinashealthcaresystem.direct-ci.com

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.

• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment Care Compare group NPD
• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1063647394
  NPD
• Wake Forest Health Network, LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD
• Jonesville Family Medical Center, P.a.

  • Family Medicine Physician
  • Jonesville, NC
  • NPI 1154437598
  NPD (past)
• Jonesville Family Medical Center, PA

  • Family Medicine Physician
  • Dobson, NC
  • NPI 1669533436
  NPD (past)
• Wake Forest Health Network LLC

  • Family Medicine Physician
  • Granite Falls, NC
  • NPI 1770858938
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164538567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S SWAIM STREET EXT",
            "city": "JONESVILLE",
            "state": "NC",
            "postal_code": "286429418",
            "telephone_number": "336-835-6300",
            "fax_number": "336-835-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S SWAIM STREET EXT",
            "city": "JONESVILLE",
            "state": "NC",
            "postal_code": "286429418",
            "telephone_number": "336-835-6300",
            "fax_number": "336-835-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBURNE",
        "first_name": "THOMAS",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "23771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975599",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "2485",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "38902",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4254883",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "75599",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omni Visions, Inc.
• Reagan Olivia Parks, FNP
• Colin Ray Rhoney, APRN
• Michael Schmitt
• Karen R. Sealey, RPH
• Melissa Shoemaker, LCMHCA
• Alisha Shupe, RN
• Mary Lee Souther, PHARMD
• Todd Harold St. John, FNP
• Jordan Gwyn Stoltzfus Hutson, MA/ED.S, LPCA, NCC

• Family Medicine Physician in Jonesville, NC
• Providers in Jonesville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.