Mackenzie Grace Shelton, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8384 Issued in GA

Practice address

11700 Mercy Blvd
Plaza D #6
Savannah, GA 31419

Phone

(912) 927-3434

Fax

(912) 921-0982

NPI assigned

Jun 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph'S Cardiology Group LLCGroup PAC ID 3274770227, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mackenzieshelton@cas.allscriptsdirect.net

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.

• St. Joseph'S Cardiology Group, LLC

  • Interventional Cardiology Physician
  • Savannah, GA
  • NPI 1619216058
  Medicare reassignment Care Compare group
• Candler ENT Practice, LLC

  • Otolaryngology Physician
  • Savannah, GA
  • NPI 1477969749
  NPD (past)

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1982134003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E 65TH STREET",
            "address_2": "SUITE 20",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 MERCY BLVD",
            "address_2": "PLAZA D #6",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31419",
            "telephone_number": "912-927-3434",
            "fax_number": "912-921-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MACKENZIE",
        "middle_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003191402A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Sheley, PA-C
• Hannah Heath Shelley
• Kirk Robert Shelley Jr., CRNA
• Robert Shelley Jr., M.D.
• Robert J Shelley, M.D.
• Caroline Shem-Tov, M.S. CCC-SLP
• Shirlonda H. Shepard, LPC
• Kaitlyn Shepherd
• Keaanna Shepherd
• Jay Sheppard

• Physician Assistant in Savannah, GA
• Providers in Savannah, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.