Paul P Shelton III, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00000758 Issued in WA

Practice address

30809 1St Ave S
Federal Way, WA 98003-4074

Phone

(253) 839-2030

NPI assigned

Jul 31, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1922014869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30809 1ST AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30809 1ST AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034074",
            "telephone_number": "253-839-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "PAUL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00000758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0199164",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1230002",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8906586",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Romana Shehzadi, MD
• Peter B Shelley, M.D.
• Tavon Shelley
• Shelby Rose Shelman, LCPO
• Daniel E Shelton, DO
• Steve Kent Shelton, LMP
• Joshua Shemon
• Peifang Shen, LMP
• Yankun Shen
• Heather Elaine Sheppard, DPT

• Family Medicine Physician in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.