Active NPI
Donnie Edwin Shelton Jr., M.D.
- Emergency Medicine Physician
- Herrin, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036121910
- Practice address
- 201 S 14TH St
Herrin, IL 62948 - Phone
- (618) 942-2171
- Fax
- (618) 351-4917
- NPI assigned
- Dec 13, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1250520017 | IL | |
| Emergency Medicine Physician | 207P00000X | 036121910 | IL | Primary |
Addresses
Primary practice location
201 S 14TH St
Herrin, IL 62948
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200
Other practice location 1
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156
Other practice location 2
305 W Jackson St
Suite 200
Carbondale, IL 62901-1474
Phone (618) 549-0721
Other practice location 3
305 W Jackson St
Suite 200
Carbondale, IL 62901-1474
Phone (618) 549-0721
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dshelton14242@sih.direct-ci.com | ||
| Direct Messaging Address | dshelton14242@sih.direct-ci.com | ||
| Direct Messaging Address | dshelton14242@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3333 W Deyoung St
Marion, IL 62959-5884
Phone (618) 998-7000
Hospital & facility affiliations
- Heartland Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.51 of 100
- Quality
- 49.04
- Promoting interoperability
- 95
- Improvement activities
- 40
- Cost
- 69.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036121910 | IL | MD | Emergency Medicine Physician |
| 1250520017 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Illinois Specialty Clinic, Inc. | Family Medicine | Current | Accepting new patients |
| Statera Health Care, LLC | Emergency Medicine | Current | Accepting new patients |
| Integritas Emergency Physician Services, LLC | Emergency Medicine | Current | Accepting new patients |
| Deaconess Illinois Specialty Clinic, Inc. | Family Medicine | Current | Accepting new patients |
| Deaconess Illinois Specialty Clinic, Inc. | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
405 W Jackson St
Carbondale, IL 62901
305 W Jackson St
Ste 200
Carbondale, IL 62901
Phone (618) 453-3777
2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691
900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050
303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020
611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
818 E Broadway St
Sparta, IL 62286
Phone (618) 443-2177
Interoperability endpoints
- dshelton14242@sih.direct-ci.com
Organizations & group practices 6
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.
-
- Surgery Physician
- Marion, IL
- NPI 1972210235
Family Medicine
-
- Emergency Medicine Physician
- Carbondale, IL
- NPI 1790128817
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- Emergency Medicine Physician
- Harrisburg, IL
- NPI 1043874449
-
- Family Medicine Physician
- Marion, IL
- NPI 1134836695
-
- Hospitalist Physician
- Anna, IL
- NPI 1225858251
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Marion, IL
- NPI 1750007266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632787200000",
"number": "1346301025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-457-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S 14TH ST",
"city": "HERRIN",
"state": "IL",
"postal_code": "62948",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4917"
}
],
"practiceLocations": [
{
"address_1": "2 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "629663333",
"country_code": "US",
"telephone_number": "618-684-3156",
"fax_number": "618-529-0524",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "305 W Jackson St",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011474",
"country_code": "US",
"telephone_number": "618-549-0721",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "305 W Jackson St",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011474",
"country_code": "US",
"telephone_number": "618-549-0721",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHELTON",
"first_name": "DONNIE",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2021-09-28",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "1250520017",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036121910",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dshelton14242@sih.direct-ci.com",
"affiliation": "N",
"address_1": "201 S 14th St",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "62948",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dshelton14242@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2 S Hospital Dr",
"city": "Murphysboro",
"state": "IL",
"country_code": "US",
"postal_code": "629663333",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dshelton14242@sih.direct-ci.com",
"affiliation": "N",
"address_1": "405 W Jackson St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011462",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.