NPIMap

Individual provider Active NPI

John R Shell, M.D.

  • Family Medicine Physician
  • Burlington, KS
National Provider Identifier
1366446221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-23694 Issued in KS
Practice address
309 Sanders St
Burlington, KS 66839-2616
Phone
(620) 364-5395
Fax
(620) 364-8719
NPI assigned
Jun 9, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-23694 KS Primary

Addresses

Primary practice location

309 Sanders St
Burlington, KS 66839-2616

Mailing address

PO Box 289
Burlington, KS 66839-0289
Phone (620) 364-5395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120116000075 KS Practitioner - Family Practice 7810958196 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffey County HospitalGroup PAC ID 4981598653, shared by 7 NPIs, 15 clinicians
Coffey County Medical CenterGroup PAC ID 4880588391, 14 clinicians

Practice addresses (Care Compare)

110 S 6TH St
Suite 202
Burlington, KS 66839-1798

309 Sanders St
Burlington, KS 66839-2616
Phone (620) 364-5395

801 N 4TH St
Burlington, KS 66839-2602
Phone 62036421214182

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-23694KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coffey County Hospital Current Accepting new patients
Coffey County Hospital Family Medicine CurrentSince Jun 19, 1992 Accepting new patients
Coffey County Hospital CurrentSince Jun 19, 1992 Accepting new patients
Coffey County Medical Center Family Medicine CurrentSince Jun 15, 1992 Accepting new patients
Coffey County Medical Center Family Medicine Past Accepting new patients
Coffey County Medical Center Past Accepting new patients
Burlington Medical Investors, LLC Past Accepting new patients

Locations

309 Sanders St
Burlington, KS 66839
Phone (620) 364-2121

801 N 4th St
Burlington, KS 66839
Phone (620) 364-2121

1004 E Madison St
Yates Center, KS 66783
Phone (620) 625-2312

Interoperability endpoints

  • Direct secure messaging: jshell@chs.securechart.com
  • Direct secure messaging: jshell@coffeyhealthdirect.org

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coffey County HospitalBurlington, KS, CCN 171385 Hospital Corporate Officer
W-2 Managing Employee (100%)		 Aug 1, 1993
Jan 1, 2017
Coffey County HospitalBurlington, KS, CCN 17Z385 Hospital Corporate Officer
W-2 Managing Employee (25%)		 Aug 1, 1993
Jan 1, 2017
Coffey County Medical Center RHCBurlington, KS, CCN 173982 Rural health clinic Corporate Officer
W-2 Managing Employee		 Nov 14, 2016
Nov 14, 2016
Waverly Medical ClinicWaverly, KS, CCN 173983 Rural health clinic Corporate Officer
W-2 Managing Employee		 Feb 1, 2014
Feb 7, 2014
Yates Center Medical Center Rural Health ClinicYates Center, KS, CCN 178559 Rural health clinic Corporate Officer (100%)
W-2 Managing Employee (100%)		 Nov 14, 2016
Nov 14, 2016

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366446221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668390289",
            "telephone_number": "620-364-5395",
            "fax_number": "620-364-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SANDERS ST",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668392616",
            "telephone_number": "620-364-5395",
            "fax_number": "620-364-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELL",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-23694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, KS

Sources for this page

Verify at the official NPI Registry.