Kimberly F Shelton, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15101 Issued in TN

Practice address

1400 Dowell Springs Blvd Ste 100
Knoxville, TN 37909-2457

Phone

(865) 437-3977

Fax

(865) 437-3912

NPI assigned

Jul 19, 2010

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Vein Center PLLCGroup PAC ID 2264727627, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.shelton.1@4694.direct.athenahealth.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.

• Legacy Vein Center PLLC

  • Vascular Surgery Physician
  • Johnson City, TN
  • NPI 1477972933
  Medicare reassignment Care Compare group NPD
• Legacy Vein Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Sevierville, TN
  • NPI 1770158859
  NPD

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1164735221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DOWELL SPRINGS BLVD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092457",
            "telephone_number": "865-437-3977",
            "fax_number": "865-439-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DOWELL SPRINGS BLVD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092457",
            "telephone_number": "865-437-3977",
            "fax_number": "865-437-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "KIMBERLY",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520351",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.shelton.1@4694.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1004 N Highway 92 Ste B",
            "city": "Jefferson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377603687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Syyrus Dashaun Shell
• Christina Shelley, LCSW
• Shannon Hill Shelley, C.N.M.
• Amber Nicole Shelton
• Carmelina Aureliana-Maria Shelton, FNP
• Lola Leeann Shelton, CRNA
• Melissa Shelton, MA
• Sarah Shelton, M.D.
• Thomas Shelton
• Elinor Shem, RDN

• Family Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.
• 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.