Individual provider Active NPI

Azure Noel Shelton, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • London, KY
National Provider Identifier
1588419980
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4015289 Issued in KY
Practice address
803 Meyers Baker Rd Ste 200
London, KY 40741-3040
Phone
(606) 878-3240
Fax
(606) 878-4308
NPI assigned
Apr 19, 2024
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4015289 KY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1172231 KY

Addresses

Primary practice location

803 Meyers Baker Rd Ste 200
London, KY 40741-3040

Mailing address

360 Arlo Barnett Rd
Parkers Lake, KY 42634
Phone (606) 310-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806000858 KY Practitioner - Nurse Practitioner 8426595695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
London Women's Care LLCGroup PAC ID 6204721566, 37 clinicians

Practice addresses (Care Compare)

803 Meyers Baker Rd
Suite 200
London, KY 40741-3040
Phone (606) 878-3240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1172231KYMDPsychiatric/Mental Health Registered Nurse

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1588419980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ARLO BARNETT RD",
            "city": "PARKERS LAKE",
            "state": "KY",
            "postal_code": "42634",
            "telephone_number": "606-310-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 MEYERS BAKER RD STE 200",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413040",
            "telephone_number": "606-878-3240",
            "fax_number": "606-878-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "AZURE",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4015289",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1172231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.