Shelly J Geloneck, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.001999 Issued in OH

Practice address

7700 Washington Village Dr Ste 220
Centerville, OH 45459-4094

Phone

(937) 438-3132

Fax

(937) 438-0902

NPI assigned

Oct 26, 2006

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

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 4

Other names 1

• Shelly J Bible Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Rajeev Mehta MD Inc

  • Specialist
  • Miamisburg, OH
  • NPI 1285694752
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1356426639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR STE 220",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594094",
            "telephone_number": "937-438-3132",
            "fax_number": "937-438-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR STE 220",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594094",
            "telephone_number": "937-438-3132",
            "fax_number": "937-438-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELONECK",
        "first_name": "SHELLY",
        "middle_name": "J",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "41.5001",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.001999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "383047893",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "383047893",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105384",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "383047893",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "BIBLE",
            "middle_name": "J",
            "credential": "P.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Centerville, OH
• Providers in Centerville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.