Individual provider Active NPI

Troy J Shelton, MD

  • Obstetrics & Gynecology Physician
  • Winona, MN
National Provider Identifier
1710997218
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
43040 Issued in MN
Practice address
855 Mankato Ave
Winona, MN 55987-4868
Phone
(507) 454-3680
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 43040 MN Primary

Addresses

Primary practice location

855 Mankato Ave
Winona, MN 55987-4868

Mailing address

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3680

Other identifiers 1

IdentifierTypeStateIssuer
026610800MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000057 MN Practitioner - Obstetrics/Gynecology 7113993510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43040MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winona Health Services CurrentSince Oct 1, 2009 Accepting new patients
Winona Health Services CurrentSince Oct 1, 2009 Accepting new patients

Locations

420 E Sarnia St
Winona, MN 55987
Phone (507) 454-3680

420 E Sarnia St
Ste 2500
Winona, MN 55987

859 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1710997218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "TROY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "43040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026610800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.