NPIMap

Individual provider Active NPI

Douglas B Shellhorn, M.D.

  • Internal Medicine Physician
  • Salisbury, NC
National Provider Identifier
1972589026
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9401333 Issued in NC
Practice address
611 Mocksville Ave
Salisbury, NC 28144-2705
Phone
(704) 633-7220
Fax
(704) 647-0515
NPI assigned
Dec 21, 2005
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9401333 NC Primary

Addresses

Primary practice location

611 Mocksville Ave
Salisbury, NC 28144-2705

Mailing address

611 Mocksville Ave
Salisbury, NC 28144-2705
Phone (704) 633-7220

Other practice location 1

1000 Brown St
Faith, NC 28041
Phone (704) 216-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000359 NC Practitioner - Internal Medicine 7911035266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wake Forest University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rowan Diagnostic Clinic PAGroup PAC ID 9335037944, 27 clinicians

Practice addresses (Care Compare)

611 Mocksville Ave
Salisbury, NC 28144-2705
Phone (704) 633-7220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rowan Diagnostic Clinic P.a. CurrentSince Sep 1, 1994 Accepting new patients
Rowan Diagnostic Clinic P.a. Internal Medicine CurrentSince Sep 1, 1994 Accepting new patients
Novant Health Rowan Medical Center LLC Past Accepting new patients

Locations

611 Mocksville Ave
Salisbury, NC 28144
Phone 7046337220269

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

Interoperability endpoints

  • Direct secure messaging: douglas.shellhorn@rowandiagnostic.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1972589026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220",
            "fax_number": "704-647-0515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Brown St",
            "address_purpose": "LOCATION",
            "city": "Faith",
            "state": "NC",
            "postal_code": "28041",
            "country_code": "US",
            "telephone_number": "704-216-7060",
            "fax_number": "704-603-8981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELLHORN",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9401333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.