Shelby Allan Comer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2019019710 Issued in MO

Practice address

Commanding Officer, 2D Denbn/NDC, PSC 20130
315 McHugh Blvd
Camp Lejeune, NC 28542-0130

Phone

(910) 451-2208

Fax

(910) 451-8479

NPI assigned

Jun 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1417518796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130",
            "address_2": "315 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130",
            "address_2": "315 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMER",
        "first_name": "SHELBY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019019710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Ditter Collado, DO
• Allison Osborne Collins, MD
• Emilie Macaire Collins, FNP-BC
• Oliver Colombine
• Denise Marie Colvin
• Stephen Joseph Connelly, DDS
• Cristin Conrad
• Aaron Christopher Conway, D.O
• Sierra Grainger Cook, RDN, LDN
• Travis Alan Cook

• Dentist in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.