Jacques L Shelton, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

COA.00847-NA Issued in OH

Practice address

234 Goodman St
Anesthesia Intensive Care Consultants Inc
Cincinnati, OH 45219-2364

Phone

(513) 558-4194

Fax

(513) 558-0995

NPI assigned

Dec 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Universtiy Anesthesia Assoc., Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Cincinnati, OH
  • NPI 1962455493
  NPD (past)

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1467437772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "address_2": "CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5502",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "address_2": "ANESTHESIA INTENSIVE CARE CONSULTANTS INC",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-558-4194",
            "fax_number": "513-558-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JACQUES",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.166462-COA1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.00847-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "617610",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74369539",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000277560",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0738778",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100388250",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "728035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelterhouse Volunteer Group
• Brooke Shelton
• Diana Shelton
• Haylee Shelton, RD
• Hilary Shelton
• Judy Ann Shelton, LPC
• Julie L Shelton, CNP
• Kathryn Shelton
• Shanice Shelton
• William Tucker Shelton, MD

• Certified Registered Nurse Anesthetist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.