Active NPI
Teresa Ann Shelton, PA-C
- Physician Assistant
- Joint Base Lewis McChord, WA
National Provider Identifier
1487965695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-02021
- Practice address
- 9040 Reid St
Joint Base Lewis McChord, WA 98431-1100 - Phone
- (253) 968-1110
- NPI assigned
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-02021 | NC | Primary |
Addresses
Primary practice location
9040 Reid St
Joint Base Lewis McChord, WA 98431-1100
Mailing address
9040 Reid St
Joint Base Lewis McChord, WA 98431-1100
Phone (253) 968-1110
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02021 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1487965695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 REID ST",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-1110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 REID ST",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-1110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "TERESA",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-02021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.