Robert L Shelly, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0252 02 00002035 Issued in WA

Practice address

551 S E Maylor St
Oak Harbor, WA 98277-5000

Phone

(360) 675-4954

Fax

(360) 675-4968

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Island Chiropractic PS IncGroup PAC ID 7315835816, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Island Chiropractic PS Inc

  • Chiropractor
  • Oak Harbor, WA
  • NPI 1831306331
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1700950102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 S E MAYLOR ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775000",
            "telephone_number": "360-675-4954",
            "fax_number": "360-675-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 S E MAYLOR ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775000",
            "telephone_number": "360-675-4954",
            "fax_number": "360-675-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "0252 02 00002035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8348112",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED ID #",
            "identifier": "91-1619092",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LICENSE #",
            "identifier": "0252-02 00002035",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seaside Psychotherapy LLC
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• Shaka Shakes, MSN
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• Gretchen Shephard
• Ariana R Sheridan, MD
• Lafe Sherrard
• Sydney Michele Shy
• Sidney J. Strother DDS, P.C.

• Chiropractor in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.