Shelton Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

601868919 Issued in WA

Legal business name

SHELTON FAMILY MEDICINE PLLC

Practice address

939 Mountain View Drive
Ste 100
Shelton, WA 98584-4410

Phone

(360) 426-2653

Fax

(360) 427-7086

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Lee Lanman

Title

Assistant Office Manager

Phone

(360) 426-2653

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

MGH Shelton Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shelton Family Medicine P.L.L.C.

  • Family Medicine Physician
  • Shelton, WA
  • NPI 1740482579
  NPD tax ID

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1609092964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 MOUNTAIN VIEW DRIVE",
            "address_2": "STE 100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-427-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 MOUNTAIN VIEW DRIVE",
            "address_2": "STE 100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-427-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "LANMAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "360-426-2653",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "601868919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ASSIGNED CLINIC NUMBER",
            "identifier": "G000247600",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelton Assisted Living
• Shelton Chiropractic and Wellness LLC
• Shelton Family Center
• Shelton Family Eye Care, LLC
• Shelton Family Medicine P.L.L.C.
• Shelton Physical Therapy and Sports Medicine Clinic P.S.
• Shelton School District
• Shelton SNF Operations, LLC
• Karen Howell Shephard, MA, MS, PHD
• Lindsey Joanne Sheppard, RN

• Family Medicine Physician in Shelton, WA
• Providers in Shelton, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.