Active NPI
Dennis Norbert Shelle, MD
- Pediatrics Physician
- Tecumseh, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301047781
- Practice address
- 6869 S Occidental Rd
Tecumseh, MI 49286-9784 - Phone
- (517) 423-4777
- Fax
- (517) 423-7257
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | DS047781 | MI | |
| Internal Medicine Physician | 207R00000X | DS047781 | MI | |
| Pediatrics Physician | 208000000X | 4301047781 | MI | Primary |
Addresses
Primary practice location
6869 S Occidental Rd
Tecumseh, MI 49286-9784
Mailing address
1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (517) 423-4777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740244789 | Medicaid | MI | |
| 2768873 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dshelle30553@epicdirect.promedica.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS047781 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Central Corporation of Michigan | Internal Medicine | Current | Accepting new patients |
Locations
501 E Cummins St
Tecumseh, MI 49286
Phone (517) 423-2960
200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883
100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964
1 Seagate
Ste 800
Toledo, OH 43604
Interoperability endpoints
- dshelle30553@direct.promedica.org
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Toledo, OH
- NPI 1588624696
Internal Medicine, MI
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Adrian, MI
- NPI 1972564730
-
dba Elara Caring
- Home Health Agency
- Jackson, MI
- NPI 1588642110
-
dba University of Michigan Health System
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
-
dba Chelsea Hospital
- General Acute Care Hospital
- Chelsea, MI
- NPI 1992761985
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1407854771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1740244789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SEAGATE STE 800",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436041558",
"telephone_number": "517-423-4777",
"fax_number": "517-423-7257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6869 S OCCIDENTAL RD",
"city": "TECUMSEH",
"state": "MI",
"postal_code": "492869784",
"telephone_number": "517-423-4777",
"fax_number": "517-423-7257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLE",
"first_name": "DENNIS",
"middle_name": "NORBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "DS047781",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "DS047781",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301047781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1740244789",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2768873",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dshelle30553@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tecumseh, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.