Kristy Shellenberger, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

OA002088 Issued in PA

Practice address

3380 Memphis St
Memphis Street Pediatrics
Philadelphia, PA 19134-4510

Phone

(215) 426-5566

Fax

(215) 739-7304

NPI assigned

Aug 22, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kshellenberger303044@upmc.direct-ci.com

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1396992251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "address_2": "MEMPHIS STREET PEDIATRICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "address_2": "MEMPHIS STREET PEDIATRICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBERGER",
        "first_name": "KRISTY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA002088",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Shelesky, PH.D.
• Yvette I Sheline, MD
• Benjamin Louis Shelkrot
• Craig Shellenberger, MS
• Deborah Shellenberger, PA-C
• Sandy Sheller, MA ATRBC
• Lennora Monique Shelley
• Mitchell Lee Shellman, MD
• Brenda Kay Shelly, CRNP
• Matthew Shelly, MD

• Medical Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.