Bernard W. Shelton, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301088798 Issued in MI

Practice address

30140 Harper Ave
Suite 300
Saint Clair Shores, MI 48082-1610

Phone

(586) 293-1868

Fax

(586) 293-1869

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1417032491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 300",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821610",
            "telephone_number": "586-293-1868",
            "fax_number": "586-293-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 300",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821610",
            "telephone_number": "586-293-1868",
            "fax_number": "586-293-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "BERNARD",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301088798",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301088798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CPIN #",
            "identifier": "70-0-F32947-0",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945780-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1417032491",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Sharpley, DDS
• Rajshekhar H Shastri, R.PH
• Neil T Shaw, DPM
• Sarah E Shea, LMSW, PH.D.
• Daniel Shelden, DO
• Chand Sheoran
• Brittany Marie Sherman
• Cynthia Shields, N.P.
• Hana Shkrela, MA, LLP
• Muhammad Shoaib, PHYSICAL THERAPIST

• Internal Medicine Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.