Active NPI
Kaitlyn Marie Shelton, PA-C
- Physician Assistant
- Matthews, NC
National Provider Identifier
1295365377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-09792
- Practice address
- 1401 Matthews Township Pkwy Ste 110
Matthews, NC 28105-5403 - Phone
- (704) 316-3131
- Fax
- (704) 316-3132
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Physician Assistant | 363A00000X | 0010-09792 | NC | Primary |
Addresses
Primary practice location
1401 Matthews Township Pkwy Ste 110
Matthews, NC 28105-5403
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-3131
Other practice location 1
1601 Brenner Ave
Salisbury, NC 28144-2515
Phone (704) 638-9000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kshelton664624@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-09792 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1295365377",
"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": "704-316-3131",
"fax_number": "704-316-3132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MATTHEWS TOWNSHIP PKWY STE 110",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281055403",
"telephone_number": "704-316-3131",
"fax_number": "704-316-3132"
}
],
"practiceLocations": [
{
"address_1": "1601 Brenner Ave",
"address_purpose": "LOCATION",
"city": "Salisbury",
"state": "NC",
"postal_code": "281442515",
"country_code": "US",
"telephone_number": "704-638-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHELTON",
"first_name": "KAITLYN",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-09792",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kshelton664624@direct.novanthealth.org",
"affiliation": "N",
"address_1": "1401 Matthews Township Pkwy Ste 110",
"city": "Matthews",
"state": "NC",
"country_code": "US",
"postal_code": "281055403",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.