Individual provider Active NPI

Matthew Joseph Shelly, D.C.

  • Chiropractor
  • Prairieville, LA
National Provider Identifier
1912142159
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1497 Issued in LA
Practice address
17534 Old Jefferson Hwy
Suite C2
Prairieville, LA 70769-3978
Phone
(985) 400-1633
NPI assigned
Dec 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1497 LA Primary

Addresses

Primary practice location

17534 Old Jefferson Hwy
Suite C2
Prairieville, LA 70769-3978

Mailing address

17534 Old Jefferson Hwy
Suite C2
Prairieville, LA 70769-3978
Phone (985) 400-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000169 LA Practitioner - Chiropractic 5395892160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17534 Old Jefferson Hwy
Suite C2
Prairieville, LA 70769-3978
Phone (985) 400-1633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1497LAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geauxchiro of Gonzales Chiropractor CurrentSince Jul 5, 2023 Accepting new patients
Shelly Chiropractic LLC Chiropractor CurrentSince Mar 1, 2015 Accepting new patients
Dynamic Performance Chiropractic of Hammond Chiropractor CurrentSince Jan 1, 2023 Accepting new patients
Acadian Chiropractic & Wellness LLC Chiropractor CurrentSince Oct 8, 2016 Accepting new patients
Curtis Health Services, LLC Chiropractor Past Accepting new patients
Optimized Living Institute PastSince Jun 24, 2026 Accepting new patients

Locations

8786 Goodwood Blvd
Ste 101
Baton Rouge, LA 70806
Phone (225) 924-5002

208 E Cornerview St
Gonzales, LA 70737
Phone (225) 644-8671

1330 S Magnolia St
Ste B
Hammond, LA 70403
Phone (225) 402-0260

17534 Old Jefferson Hwy
Ste C2
Prairieville, LA 70769
Phone (985) 400-1633

17557 Old Jefferson Hwy
#102
Prairieville, LA 70769

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1912142159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17534 OLD JEFFERSON HWY",
            "address_2": "SUITE C2",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693978",
            "telephone_number": "985-400-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17534 OLD JEFFERSON HWY",
            "address_2": "SUITE C2",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693978",
            "telephone_number": "985-400-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-02",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.