Active NPI
Wanda S Shelton, FNP
- Family Medicine Physician
- Erwin, TN
National Provider Identifier
1922051010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- RN0000049950
- Practice address
- 105 Gay St
Erwin, TN 37650 - Phone
- (423) 743-6141
- Fax
- (423) 743-1083
- NPI assigned
- May 18, 2006
- Last updated
- Nov 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | RN0000049950 | TN | Primary |
Addresses
Primary practice location
105 Gay St
Erwin, TN 37650
Mailing address
PO Box 399
Erwin, TN 37650
Phone (423) 743-6141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3380594 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000049950 | TN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1922051010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 399",
"city": "ERWIN",
"state": "TN",
"postal_code": "37650",
"telephone_number": "423-743-6141",
"fax_number": "423-743-1083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 GAY ST",
"city": "ERWIN",
"state": "TN",
"postal_code": "37650",
"telephone_number": "423-743-6141",
"fax_number": "423-743-1083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "WANDA",
"middle_name": "S",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "RN0000049950",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3380594",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erwin, TN
- Christa Rosier, CCC, SLP
- Rural Health Services Consortium of Upper East Tennessee Inc (Dry Creek Medical Center)
- Rebecca Sacora, M.D.
- Marc Winter Schlemmer, RPH
- Jacqui Renee Schollenberger, LCSW
- Charlotte Freeman Shores, BSW
- Candace Simerly, PT
- John Slaughter, PHARM.D.
- Trula Jean Sneyd, CNA 2
- Joseph C Snyder Jr., DPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.