Individual provider Active NPI

Shelby Wilson, DC

  • Chiropractor
  • Halstead, KS
National Provider Identifier
1306440979
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0106089 Issued in KS
Practice address
718 Chestnut St
Halstead, KS 67056-2305
Phone
(620) 382-5713
NPI assigned
Nov 24, 2020
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0106089 KS Primary

Addresses

Primary practice location

718 Chestnut St
Halstead, KS 67056-2305

Mailing address

718 Chestnut St
Halstead, KS 67056-2305
Phone (620) 382-5713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120000937 KS Practitioner - Chiropractic 2961873484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Health and Wellness Center, L.L.C.Group PAC ID 1557423258, 2 clinicians

Practice addresses (Care Compare)

1319 E 1St St
McPherson, KS 67460-3601
Phone (620) 504-6344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0106089KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Chiropractic LLC Chiropractor CurrentSince Feb 1, 2023 Accepting new patients

Locations

430 Victoria Rd
Newton, KS 67114
Phone (316) 804-7095

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1306440979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 CHESTNUT ST",
            "city": "HALSTEAD",
            "state": "KS",
            "postal_code": "670562305",
            "telephone_number": "620-382-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 CHESTNUT ST",
            "city": "HALSTEAD",
            "state": "KS",
            "postal_code": "670562305",
            "telephone_number": "620-382-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "0106089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halstead, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.