Shelley Rae Stanton, M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

28987 Issued in WI

Practice address

1100 Bergslien St
Baldwin, WI 54002-2600

Phone

(715) 684-1111

NPI assigned

Oct 22, 2015

Last updated

Mar 22, 2018By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1811369473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E CENTER ST",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044754",
            "telephone_number": "507-424-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "SHELLEY",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "WI",
            "license": "28987",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "WI",
            "license": "28987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Psychiatry Physician in Baldwin, WI
• Providers in Baldwin, WI by specialty
• Geriatric Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.