Keith a Shelton

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KEITH A SHELTON

Practice address

200 N 10TH St
Poplar Bluff, MO 63901-4856

Phone

(573) 686-7216

Fax

(573) 686-7217

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Keith A Shelton, RPHNPI 1285954750

Title

Owner

Phone

(573) 686-7216

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith Alan Shelton, RPH

  • Pharmacist
  • Poplar Bluff, MO
  • NPI 1285954750
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1508950916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 10TH ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N 10TH ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014856",
            "telephone_number": "573-686-7216",
            "fax_number": "573-686-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH A SHELTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-686-7216",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "004034",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621708502",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601708506",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2619231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Doris Keasler, LPC
• Keeling and Keeling Enterprises LLC
• James Dennis Keeling, M.A., CCC-SLP
• Sandra L. Keeling, LPC
• Kristy Michelle Keirsey, RDH
• Melissa Keith, APRN-BC
• Carol Marie Kellison
• Simeon Sky Kelly
• John Judson Kersbergen, PHARMACIST
• Raymond Benjamin Ketting, M.D.

• Community/Retail Pharmacy in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.