Active NPI
Elevate Urology LLC
- Urology Physician
- Glastonbury, CT
National Provider Identifier
1710813233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- ELEVATE UROLOGY LLC
- Practice address
- 730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016 - Phone
- (860) 266-5550
- Fax
- (860) 266-5511
- NPI assigned
- Jun 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shanta Shepherd, MD
- Title
- Owner
- Phone
- (860) 266-5550
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016
Mailing address
730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016
Phone (860) 266-5550
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Urology Physician
- Glastonbury, CT
- NPI 1174986756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782086400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788307200000",
"number": "1710813233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 HEBRON AVE STE 10",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060335016",
"telephone_number": "860-266-5550",
"fax_number": "860-266-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 HEBRON AVE STE 10",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060335016",
"telephone_number": "860-266-5550",
"fax_number": "860-266-5511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELEVATE UROLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-06-22",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A",
"authorized_official_last_name": "SHEPHERD",
"authorized_official_first_name": "SHANTA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "860-266-5550",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.