Individual provider Active NPI

Zachary Usher Shelton, D.D.S.

  • Dentist
  • Manchester, TN
National Provider Identifier
1629206107
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9027 Issued in TN
Practice address
1626 McArthur St
Manchester, TN 37355-2522
Phone
(931) 728-0313
NPI assigned
Jun 23, 2009
Last updated
Jun 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9027 TN Primary

Addresses

Primary practice location

1626 McArthur St
Manchester, TN 37355-2522

Mailing address

654 Indian Springs Cir
Manchester, TN 37355-8463
Phone (931) 273-9747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150824000289 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315252160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9027TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
SD.Shelton Family Dentistry Dentist Past Accepting new patients

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1629206107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 INDIAN SPRINGS CIR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373558463",
            "telephone_number": "931-273-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552522",
            "telephone_number": "931-728-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "ZACHARY",
        "middle_name": "USHER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

Verify at the official NPI Registry.