Active NPI
Carlos Shelton
- Adult Health Nurse Practitioner
- Allen Park, MI
National Provider Identifier
1326478637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 4704247721
- Practice address
- 7445 Allen Rd Ste 250
Allen Park, MI 48101-1959 - Phone
- (313) 386-5500
- NPI assigned
- Nov 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704247721 | MI | Primary |
Addresses
Primary practice location
7445 Allen Rd Ste 250
Allen Park, MI 48101-1959
Mailing address
539 Mayflower Ave
Lincoln Park, MI 48146-3039
Phone (313) 516-1512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704247721 | MI | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- carlosshelton@wwp.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385078400000",
"number": "1326478637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 MAYFLOWER AVE",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481463039",
"telephone_number": "313-516-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7445 ALLEN RD STE 250",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481011959",
"telephone_number": "313-386-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "CARLOS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-22",
"last_updated": "2013-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704247721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.