Grover Alexander Shelton III, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71008853A Issued in IN

Practice address

8075 N Shadeland Ave Ste 200
Indianapolis, IN 46250

Phone

(317) 621-8500

NPI assigned

Nov 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gshelton338130@ecommunitydirect.com

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

• Community Physician Network Specialty Care LLC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1588535496
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  Nurse Practitioner

  Medicare reassignment NPD
• University Surgeons, Inc.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1316966229
  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1316415136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46250",
            "telephone_number": "317-621-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14602 Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441075927",
            "country_code": "US",
            "telephone_number": "317-332-8367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5255 E Stop 11 Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462376341",
            "country_code": "US",
            "telephone_number": "317-528-4723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "GROVER",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-09",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "429527",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008853A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023898",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Shelley, DO
• Emily W Shelley, D.O.
• Lori Shelley, PHARM D
• Dacia L Shelman
• Beth A Shelton, MD
• Harmony Shelton
• Lamyah Shelton
• Laveena Shelton
• Margarette L Shelton, PHD, OTR
• Michaiah Ann Shelton, BS

• Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
• 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.