Shelby Lynn Wilbourn, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

016025 Issued in ME

Practice address

1600 S Andrews Ave
Suite 323 West Wing
Fort Lauderdale, FL 33316-2510

Phone

(954) 355-5110

Fax

(954) 355-4919

NPI assigned

Nov 29, 2006

Last updated

Mar 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premiere Perinatal Associates PA

  • Maternal & Fetal Medicine Physician
  • Davie, FL
  • NPI 1467128462
  NPD (past)
• Mainehealth

  dba MaineHealth Waldo Hospital

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1770650764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "address_2": "SUITE 323 WEST WING",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-5110",
            "fax_number": "954-355-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "address_2": "SUITE 323 WEST WING",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-5110",
            "fax_number": "954-355-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBOURN",
        "first_name": "SHELBY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": "016025",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "FL",
            "license": "ME106484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Wigdor, D.O.
• Laure'-Ann Wiggan-Lampart, M.D.
• David Wiggins, MD
• Paul Wigoda, M.D.
• Emily Marie Wilbar, OTR/L
• Heather Nicole Wilbur, APRN
• Chelsea Wilcocks, PSYD
• Eric Christopher Wilkerson, MD
• Natasha Wilkes, FNP-BC
• Shanique E Wilkinson

• Obstetrics & Gynecology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.