Active NPI
William C. Shell, M.D.
- Internal Medicine Physician
- Sikeston, MO
National Provider Identifier
1407834849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD28469
- Practice address
- 1012 N Main St
Sikeston, MO 63801-5044 - Phone
- (573) 431-0330
- Fax
- (573) 472-2966
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD28469 | MO | Primary |
Addresses
Primary practice location
1012 N Main St
Sikeston, MO 63801-5044
Mailing address
PO Box 1068
Sikeston, MO 63801-1068
Phone (573) 431-0330
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43074141063801A085 | Other | MO | TRICARE |
| 132510 | Other | MO | HEALTHLINK NUMBER |
| 27441 | Other | MO | BCBS MO NUMBER |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD28469 | MO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1407834849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1068",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638011068",
"telephone_number": "573-431-0330",
"fax_number": "573-472-2966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 N MAIN ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638015044",
"telephone_number": "573-431-0330",
"fax_number": "573-472-2966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELL",
"first_name": "WILLIAM",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "MD28469",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "43074141063801A085",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK NUMBER",
"identifier": "132510",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MO NUMBER",
"identifier": "27441",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sikeston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.