Individual provider Active NPI

Craig Ricardo Shelton, DPM

  • Podiatrist
  • Ypsilanti, MI
National Provider Identifier
1871676817
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001715 Issued in MI
Practice address
103 Dr John C Shelton Blvd
Ypsilanti, MI 48197-5412
Phone
(734) 487-5007
Fax
(734) 487-5259
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001715 MI Primary

Addresses

Primary practice location

103 Dr John C Shelton Blvd
Ypsilanti, MI 48197-5412

Mailing address

103 Dr John C Shelton Blvd
Ypsilanti, MI 48197-5412
Phone (734) 487-5007

Other identifiers 3

IdentifierTypeStateIssuer
3297390MedicaidMI
480025231OtherMIMEDICARE RAILROAD
4858154280OtherMIBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000191 MI Practitioner - Podiatry 1850411810 Practice locations: Ypsilanti, MI

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 Ferris St
Ypsilanti, MI 48197-5412
Phone (734) 487-5007

5341 McAuley Dr
Ypsilanti, MI 48197-9808
Phone (734) 712-1600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue30
Removal of skin lesions1-10
Removal of nail tissue356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1871676817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 DR JOHN C SHELTON BLVD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975412",
            "telephone_number": "734-487-5007",
            "fax_number": "734-487-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 DR JOHN C SHELTON BLVD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975412",
            "telephone_number": "734-487-5007",
            "fax_number": "734-487-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "CRAIG",
        "middle_name": "RICARDO",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3297390",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480025231",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4858154280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.