Active NPI
Imisha Nikole Shelton
- Religious Nonmedical Practitioner
- Cedar Hill, TX
National Provider Identifier
1548021371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Practitioner
- Practice address
- 1285 Longleaf Dr
Cedar Hill, TX 75104-5457 - Phone
- (214) 296-7122
- NPI assigned
- Jan 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | TX | ||
| Behavior Technician | 106S00000X | RBT-23-265169 | TX | |
| Nutritionist | 133N00000X | |||
| Nutrition Education Nutritionist | 133NN1002X | |||
| Health & Wellness Coach | 171400000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Peer Specialist | 175T00000X | |||
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | |||
| Home Health Aide | 374U00000X | |||
| Religious Nonmedical Practitioner | 374K00000X | Primary | ||
| Contractor | 171W00000X | |||
| Driver | 172A00000X | |||
| Homeopath | 175L00000X |
Addresses
Primary practice location
1285 Longleaf Dr
Cedar Hill, TX 75104-5457
Mailing address
1285 Longleaf Dr
Cedar Hill, TX 75104-5457
Phone (214) 296-7122
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 |
|---|---|---|---|
| RBT-23-265169 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1548021371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1285 LONGLEAF DR",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751045457",
"telephone_number": "214-296-7122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1285 LONGLEAF DR",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751045457",
"telephone_number": "214-296-7122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "IMISHA",
"middle_name": "NIKOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-18",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-23-265169",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": null,
"license": null,
"primary": true
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "175L00000X",
"taxonomy_group": "",
"desc": "Homeopath",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cedar Hill, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.