Active NPI
Dane Shell
- Physician Assistant
- Wilmington, NC
National Provider Identifier
1508437344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-11631
- Practice address
- 2520 Troy Dr
Wilmington, NC 28401-7661 - Phone
- (910) 444-7068
- NPI assigned
- Jul 2, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 0010-11631 | NC | Primary |
Addresses
Primary practice location
2520 Troy Dr
Wilmington, NC 28401-7661
Mailing address
625 Old Peachtree Rd NW
Suwanee, GA 30024-2937
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theoria Medical | Physician Assistant | Current | Accepting new patients |
| Complexcare Medical Group Mid-Atlantic H PLLC | Current | Accepting new patients |
Locations
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
411 S Lasalle St
Durham, NC 27705
Phone (919) 383-5521
430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Novi, MI
- NPI 1275427429
NC
-
- Addiction Medicine (Internal Medicine) Physician
- Wilmington, NC
- NPI 1588151294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1508437344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 OLD PEACHTREE RD NW",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300242937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 TROY DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017661",
"telephone_number": "910-444-7068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELL",
"first_name": "DANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-02",
"last_updated": "2022-01-07",
"certification_date": "2021-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-11631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.