Individual provider Active NPI

Burton Otis Shelton, FNP C

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1184685687
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201895 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-7080
Fax
(336) 718-9622
NPI assigned
Apr 1, 2006
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201895 NC Primary
Cardiovascular Disease Physician 207RC0000X 201895 NC

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-7080

Other identifiers 1

IdentifierTypeStateIssuer
7005844MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bshelton22673@direct.novanthealth.org

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051214000740 NC Practitioner - Nurse Practitioner 5294756599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201895NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc Cardiovascular Disease CurrentSince Mar 13, 2012 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 16, 2014 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 16, 2014 Accepting new patients
Forsyth Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Mar 13, 2012 Accepting new patients

Locations

108 Providence Rd
Charlotte, NC 28207
Phone (336) 277-3431

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

125 Queens Rd
Charlotte, NC 28204
Phone (704) 384-5043

4136 Clemmons Rd
Clemmons, NC 27012
Phone (336) 893-1300

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

7114 Village Medical Cir
Clemmons, NC 27012
Phone (336) 893-2440

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

3515 W Market St
Ste 110
Greensboro, NC 27403
Phone (336) 299-0099

1710 Kernersville Medical Pkwy
Ste 205
Kernersville, NC 27284
Phone (336) 983-4500

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

250 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 718-1000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: bshelton22673@direct.novanthealth.org

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1184685687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "BURTON",
        "middle_name": "OTIS",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201895",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "201895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005844",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bshelton22673@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.