Individual provider Active NPI

Richard Schellin, DO

  • Diagnostic Radiology Physician
  • Aledo, TX
National Provider Identifier
1326102591
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DOG7582 Issued in TX
Practice address
3904 Lost Creek Blvd
Aledo, TX 76008-3656
Phone
(817) 244-0904
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DOG7582 TX Primary

Addresses

Primary practice location

3904 Lost Creek Blvd
Aledo, TX 76008-3656

Mailing address

3904 Lost Creek Blvd
Aledo, TX 76008-3656
Phone (817) 244-0904

Other identifiers 5

IdentifierTypeStateIssuer
P00110017OtherTXPALMETTO
0089KJOtherTXBCBS
132273707MedicaidTX
10029312OtherTXAMERIGROUP
DOG7582OtherTXLIC NUMBER

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
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DOG7582TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nanette V Evans M.D., P.a. Diagnostic Radiology Past Accepting new patients
Weatherford Radiology PLLC Diagnostic Radiology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1326102591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 LOST CREEK BLVD",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760083656",
            "telephone_number": "817-244-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 LOST CREEK BLVD",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760083656",
            "telephone_number": "817-244-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLIN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "DOG7582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "P00110017",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0089KJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132273707",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10029312",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC NUMBER",
            "identifier": "DOG7582",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aledo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.