Samuel Edward Shelton

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61096158 Issued in WA

Practice address

817 238TH St SE Ste H
Bothell, WA 98021-4309

Phone

(425) 820-4717

NPI assigned

Oct 19, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Multi-Specialty

  Medicare reassignment NPD
• Multicare Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1154818326
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1477064236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 238TH ST SE STE H",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214309",
            "telephone_number": "425-820-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 238TH ST SE STE H",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214309",
            "telephone_number": "425-820-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "SAMUEL",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-19",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61096158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSWAIC",
            "identifier": "SC60701093",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priya Shankarganesh
• Parul Sharma, DO
• Ruchi Gupta Sharma, M.D.
• Peggy Jo Shaw
• Suzanne Marie Shay, D.C.
• Shema Counseling and Coaching
• Suzanna Shepherd
• Shannon Sherman
• Zosia M.F. Sherwood, HS, AA, BS, CBT
• Emily Caroline Shields

• Clinical Social Worker in Bothell, WA
• Providers in Bothell, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.