Shelley Anderson, D.C.
Individual provider Active NPI Chiropractor · Wellington, FL
NPI 1245686708 · NPPES record last updated Mar 6, 2020
Key facts
- NPI
- 1245686708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH11633 (FL)
- Practice address
- 13861 Folkestone Cir Apt D
Wellington, FL 33414-7829 - Phone
- (585) 576-7890
- NPI assigned
- May 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
778 W Midway Rd
Fort Pierce, FL 34982-4203
Phone (585) 576-7890
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180329001333 | FL | Practitioner - Chiropractic | 1557627981 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH11633 | FL | MD | Chiropractor |
| 012687 | NY | MD | Chiropractor |
| 4973 | NC | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terrapin Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
Locations
778 W Midway Rd
Fort Pierce, FL 34982
Phone (585) 576-7890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4973 | NC | |
| Chiropractor | 111N00000X | 012687 | NY | |
| Chiropractor | 111N00000X | CH11633 | FL | Yes |
Addresses
Primary practice location
13861 Folkestone Cir Apt D
Wellington, FL 33414-7829
Mailing address
13861 Folkestone Cir Apt D
Wellington, FL 33414-7829
Phone (585) 576-7890
Other names
- Dr. Shelley Moore
Other providers in Wellington, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.