NPIMap

Individual provider Active NPI

Shelby Wegman, PA-C

  • Surgical Physician Assistant
  • Rockwall, TX
National Provider Identifier
1689328650
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA15331 Issued in TX
Practice address
3142 Horizon Rd Ste 100
Rockwall, TX 75032-7815
Phone
(817) 442-9300
Fax
(844) 358-4178
NPI assigned
Feb 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X PA15331 TX
Surgical Physician Assistant 363AS0400X PA15331 TX Primary

Addresses

Primary practice location

3142 Horizon Rd Ste 100
Rockwall, TX 75032-7815

Mailing address

8350 Dallas Pkwy Ste 300
Frisco, TX 75034-5076
Phone (972) 377-9200

Other practice location 1

8350 Dallas Pkwy Ste 300
Frisco, TX 75034-5076
Phone (972) 377-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220416000105 TX Practitioner - Physician Assistant 3173919826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Back CareGroup PAC ID 1951604313, 50 clinicians

Practice addresses (Care Compare)

1545 E Southlake Blvd
Southlake, TX 76092-6422
Phone (817) 748-8701

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6465
Phone (682) 651-1908

3142 Horizon Rd
Suite 100
Rockwall, TX 75032-7815
Phone (817) 442-9300

3150 Horizon Rd
Rockwall, TX 75032-7805
Phone (469) 698-1510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Back Care Neurological Surgery CurrentSince Apr 1, 2024 Accepting new patients

Locations

1340 S Main St
Ste 100
Grapevine, TX 76051
Phone (682) 651-1908

3509 Spectrum Blvd
#B
Richardson, TX 75082
Phone (972) 772-9600

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

1545 E Southlake Blvd
Southlake, TX 76092
Phone (817) 557-8205

Organizations & group practices 2

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1689328650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 DALLAS PKWY STE 300",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345076",
            "telephone_number": "972-377-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327815",
            "telephone_number": "817-442-9300",
            "fax_number": "844-358-4178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Dallas Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750345076",
            "country_code": "US",
            "telephone_number": "972-377-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGMAN",
        "first_name": "SHELBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "PA15331",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA15331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.