Robert Shelton Jr.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Practice address

3504 Mt Vernon Ave
Fort Worth, TX 76103-2527

Phone

(214) 900-8360

NPI assigned

Feb 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Loyal Living LLC.

  • Adult Mental Health Clinic/Center
  • Fort Worth, TX
  • NPI 1144956673
  NPD Authorized official

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1740933316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181698",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760961698",
            "telephone_number": "214-900-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 MT VERNON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761032527",
            "telephone_number": "214-900-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "ROBERT",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Huntly Elberto Shelton III, PH.D.
• Joseph Houston Shelton, M.D.
• Mark M Shelton, MD
• Nicole Shelton, PMHNP-BC
• Rebecca L Shelton, LCSW
• Suzzette M Shelton, L.C.D.C.
• Sandy Cho Shemme, LVN
• Darryl Shepard, CPT
• Susan Schlosser Shepard, LMFT, LPC
• Melody Joy Shepherd Valley, EDD, CCC-SLP

• Adult Day Care Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.