DR. MICHAEL VISE SHELTON (NPI# 1003810995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003810995 |
Entity Type | Individual |
Full Name | DR. MICHAEL VISE SHELTON |
Credential | M.D. |
Practice Address |
4222 Wendover Ave Ste 600 Odessa TX 79762-5983 |
Practice Telephone | 4325525656 |
Practice Fax Number | 4325520992 |
Mailing Telephone | 4325525656 |
Mailing Fax Number | 4325520992 |
Enumeration Date | 2005-06-08 |
Last Update Date | 2010-07-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | E8905 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 133690105 | 05 | |
TX | BLUE CROSS/BLUE SHIELD | 89030X | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205205226 | Michael Shelton | Counselor | 525 South 4th Street, Suite 471, Equilibria, Philadelphia, PA 19147 | 2015-09-21 |
1801917208 | Michael Lynn Shelton | Non-emergency Medical Transport (VAN) | 622 Lazy Ln, Mount Carmel, TN 37645 | 2007-04-03 |
1225124407 | Michael W Shelton | Family Medicine | 2715 Morrison St, Houston, TX 77009-7613 | 2006-10-05 |
1235241977 | Michael E Shelton | Dentist | 1425 Mcarthur St, Manchester, TN 37355-2517 | 2006-08-31 |
1396372033 | Michael Alan Shelton | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-24 |
1346887320 | Michael Shelton | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2019-12-09 |
1326329426 | Michael Jesse Shelton | Pharmacist | 919 W Mercury Blvd, Hampton, VA 23666-4322 | 2011-09-01 |
1124251103 | Michael Tyshune Shelton | Registered Nurse | 315 N San Saba Ste 1075, San Antonio, TX 78207-3155 | 2009-08-25 |
1962687301 | Michael Scott Shelton | Occupational Therapy Assistant | 5901 Broken Sound Pkwy Ste 500, Boca Raton, FL 33487-2791 | 2008-01-03 |
1639350051 | Michael L. Shelton | Anesthesiology | 840 Montclair Rd, Suite 317, Birmingham, AL 35213-1920 | 2007-11-14 |
Street Address |
4222 WENDOVER AVE STE 600 |
City | ODESSA |
State | TX |
Zip Code | 79762-5983 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528210762 | Laura Lee Tarabocchia | Nurse Practitioner | 4222 Wendover Ave, #400, Odessa, TX 79762-5945 | 2008-10-21 |
1801090865 | Lori Jo Wingate | Nurse Practitioner | 4222 Wendover Ave, 400, Odessa, TX 79762-5945 | 2007-06-13 |
1356374854 | First Physicians, Pa | Family Medicine | 4222 Wendover Ave, Suite 600, Odessa, TX 79762-5945 | 2006-07-08 |
1245273325 | Ronell Jean Carlson | Nurse Practitioner | 4222 Wendover Ave, Suite 600, Odessa, TX 79762-5945 | 2006-06-14 |
1598741480 | Terry M Unruh | Specialist | 4222 Wendover Ave, Suite 800, Odessa, TX 79762-5945 | 2005-12-21 |
1467441642 | David Barry Willingham | Family Medicine | 4222 Wendover Ave, Suite 600, Odessa, TX 79762-5945 | 2005-10-19 |
1912909789 | Bret Alan Baker | Physician Assistant | 4222 Wendover Ave, Suite 600, Odessa, TX 79762-5945 | 2005-08-11 |
1053318915 | Anne E Acreman | Family Medicine | 4222 Wendover Ave, Suite 400, Odessa, TX 79762-5945 | 2005-07-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982256798 | Winwood Dental and Orthodontics Pllc | Dentist | 3913 E 42nd Street, Odessa, TX 79762 | 2019-07-11 |
1265995716 | Ryan Daniels | Specialist/Technologist | 4901 E University, Gym 111, Odessa, TX 79762 | 2019-04-11 |
1215429592 | Michael Wayne Samp | Respiratory Therapist, Registered | 2807 Windsor Dr, Odessa, TX 79762 | 2018-06-03 |
1972003663 | Kristi Young | Registered Nurse | 3800 E. 42nd St., Suite 203 Attn: Pediatric Dept, Odessa, TX 79762 | 2018-02-19 |
1427508902 | Whitney Diakur | Optometrist | 5011 E. 42nd St, Odessa, TX 79762 | 2016-10-10 |
1295184927 | Farqad Kamal Abuoudeh | Dentist | 6109 Tx-191 Frontage, Odessa, TX 79762 | 2016-06-03 |
1457714180 | Daniel & Max, LLC | Optometrist | 5011 E. 42nd Street, Odessa, TX 79762 | 2016-03-31 |
1407225774 | Neri Campos-gardea | Massage Therapist | 3952 E 42d, Odessa, TX 79762 | 2015-09-17 |
1508255886 | Permian Er IIi | Clinic/Center | 6131 East Highway 191, Odessa, TX 79762 | 2015-01-09 |
1548675861 | Tina Desai | Dentist | 6109 Texas 191, Odessa, TX 79762 | 2014-06-25 |
Find all providers in zip 79762 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376150102 | Paul Joseph Baquirin | Family Medicine | 1403 E Century Ave, Odessa, TX 79762-7743 | 2020-09-25 |
1972868974 | Carehere LLC | Family Medicine | 2330 W 10th St, Odessa, TX 79763-3782 | 2012-07-06 |
1376807362 | Mavis Twum-barimah | Family Medicine | 6030 W University Blvd, Odessa, TX 79764-8530 | 2012-06-25 |
1962761791 | Marvin Ryan Harvey | Family Medicine | 701 W 5th St Ste 3174, Odessa, TX 79763 | 2012-05-14 |
1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
1043517204 | Scotty Ortega Pa | Family Medicine | 4415 Hinkle St, Odessa, TX 79762-4626 | 2011-02-23 |
1265763130 | Robert James Ailes | Family Medicine | 16641 Ivy Lake Dr, Odessa, FL 33556-6019 | 2010-01-16 |
1609020452 | Leo Villaroman, Md, Pa | Family Medicine | 501 Golder Ave, Suite 203, Odessa, TX 79761-4411 | 2008-11-06 |
1568640365 | John Garcia Md Pa | Family Medicine | 601 East 7th Street, Odessa, TX 79761 | 2008-02-04 |
1023224904 | Odessa Medical Clinic PC | Family Medicine | 316 W Us Highway 40, Odessa, MO 64076-7445 | 2007-05-15 |
Find all providers in ODESSA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.