Individual provider Active NPI

Shelby Taylor Wait, FNP

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1376012823
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP139586 Issued in TX
Practice address
8201 Ewing Halsell Dr FL 2
San Antonio, TX 78229-3707
Phone
(210) 575-7400
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139586 TX
Nurse Practitioner 363L00000X AP139586 TX Primary

Addresses

Primary practice location

8201 Ewing Halsell Dr FL 2
San Antonio, TX 78229-3707

Mailing address

8201 Ewing Halsell Dr
San Antonio, TX 78229-3707
Phone (210) 575-4837

Other identifiers 2

IdentifierTypeStateIssuer
396390201MedicaidTX
765966OtherTXMCR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP139586TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Davids Heart & Vascular, PLLC PastSince Jan 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shelby.wait@hca7.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1376012823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 EWING HALSELL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293707",
            "telephone_number": "210-575-4837",
            "fax_number": "210-575-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 EWING HALSELL DR FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293707",
            "telephone_number": "210-575-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIT",
        "first_name": "SHELBY",
        "middle_name": "TAYLOR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139586",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396390201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR PTAN",
            "identifier": "765966",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.