Carson Donald Shell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22216 Issued in MI

Practice address

7800 US 131 S
Cadillac, MI 49601-7080

Phone

(231) 775-9797

Fax

(231) 775-9793

NPI assigned

Apr 12, 2017

Last updated

Apr 3, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1306370812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 LAURELWOOD CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082517",
            "telephone_number": "231-775-9797",
            "fax_number": "231-775-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 US 131 S",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496017080",
            "telephone_number": "231-775-9797",
            "fax_number": "231-775-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELL",
        "first_name": "CARSON",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "22216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.