Clough Shelton, MD

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

License

267419-1205 Issued in UT

Practice address

100 N Medical Dr
Salt Lake City, UT 84113-1103

Phone

(801) 588-2700

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1891885414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581094",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581094",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-588-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "CLOUGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "UT",
            "license": "267419-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003084600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040006913",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Bigham Shelley
• Thomas Duane Shelley, PHARMD
• Daniel Shelly, DPT, ATC
• Logan C. Shelnutt, MD
• Abbilynn Shelton
• Richard Stewart Shelton, M.D.
• Katherine Anne Shen, M.D
• Mia Jane Sheneman
• Sally Shenk-Fuegi, RN, MN, FNP
• Ian Courtney Shenk

• Otology & Neurotology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Otology & Neurotology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.