Individual provider Active NPI

Robert Shelley Jr., M.D.

  • Orthopaedic Surgery Physician
  • Savannah, GA
National Provider Identifier
1326422171
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
87543 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone
(912) 644-5300
NPI assigned
Jul 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 7557 GA
Orthopaedic Surgery Physician 207X00000X 53449 KY
Orthopaedic Surgery Physician 207X00000X 87543 GA Primary

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405-6736

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.shelley.1@16403.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210324000917 GA Practitioner - Orthopedic Surgery 4284942996 Reassigns benefits to 2 organizations
I20220505002617 SC Practitioner - Orthopedic Surgery 4284942996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Georgia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optim Orthopedics LLCGroup PAC ID 9931427002, shared by 9 NPIs, 101 clinicians
Tattnall Hospital Company LLCGroup PAC ID 6204907124, 47 clinicians

Practice addresses (Care Compare)

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

8201 Pinellas Dr
Bluffton, SC 29910-4133
Phone (843) 705-9401

821 S Main St
Suite C
Baxley, GA 31513-0163
Phone (912) 705-8040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.22 of 100Reported as group
Quality
71.46
Promoting interoperability
0
Improvement activities
40
Cost
59.28

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement48
Knee replacement40
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7557GAMDOrthopaedic Surgery Physician
87543GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optim Orthopedics, LLC Orthopaedic Surgery CurrentSince May 1, 2021 Accepting new patients
Optim Orthopedics, LLC Orthopaedic Surgery CurrentSince May 1, 2021 Accepting new patients
Tattnall Hospital Company, LLC Orthopaedic Surgery CurrentSince Jun 1, 2021 Accepting new patients
Optim Orthopedics, LLC Orthopaedic Surgery CurrentSince Jan 13, 2022 Accepting new patients
Tattnall Hospital Company, LLC Current Accepting new patients
Tattnall Hospital Company LLC Orthopaedic Surgery Past Accepting new patients
Tattnall Hospital Company, LLC Orthopaedic Surgery Past Accepting new patients
Tattnall Hospital Company, LLC Orthopaedic Surgery Past Accepting new patients
Tattnall Hospital Company, LLC Orthopaedic Surgery Past Accepting new patients
Tattnall Hospital Company, LLC Orthopaedic Surgery Past Accepting new patients
Optim Orthopedics, LLC Orthopaedic Surgery Past Accepting new patients
Optim Orthopedics, LLC Orthopaedic Surgery PastSince Oct 6, 2019 Accepting new patients

Locations

821 S Main St
Ste C
Baxley, GA 31513
Phone (912) 367-5486

242 Industrial Blvd
Dublin, GA 31021
Phone (478) 272-3140

790 Veterans Parkway
Ste 111
Hinesville, GA 31313
Phone (912) 368-3868

961 E Winthrope Ave
Millen, GA 30442
Phone (478) 982-0120

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

101 W Mulberry Blvd
Ste 140
Savannah, GA 31407
Phone (912) 348-9500

119B Victory Dr
Swainsboro, GA 30401
Phone (478) 237-7676

102 Rocky Ford Rd
Sylvania, GA 30467
Phone (912) 564-2155

209 Mims Rd
#A
Sylvania, GA 30467
Phone (912) 564-5236

8201 Pinellas Dr
Bluffton, SC 29910
Phone (843) 705-9401

Interoperability endpoints

  • Direct secure messaging: rshelley191955@direct.nortonhealthcare.org

Organizations & group practices 12

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1326422171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "7557",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "53449",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "87543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.shelley.1@16403.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "210 E DeRenne Ave",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314056736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.