DR. JOHN DANIEL SHELBURNE (NPI# 1447358379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447358379 |
| Entity Type | Individual |
| Full Name | DR. JOHN DANIEL SHELBURNE |
| Credential | M.D. |
| Practice Address |
508 Fulton St V.a. Medical Center Durham NC 27705-3875 |
| Practice Telephone | 9192866907 |
| Practice Fax Number | 9194165950 |
| Mailing Telephone | 9192866907 |
| Mailing Fax Number | 9194165950 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
18057 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
508 FULTON ST V.A. MEDICAL CENTER |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043217086 | Stuart Hall Manning | Internal Medicine | 508 Fulton St, C/o Durham Va Medical Center, Durham, NC 27705-3875 | 2005-07-06 |
| 1245839083 | Jessica Elizabeth Cornett | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1174122055 | Aline Xayasouk | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-21 |
| 1730786187 | Kathryn Masincupp | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-07 |
| 1700490349 | Sarah Elizabeth Parker | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2020-09-01 |
| 1144833716 | Phillip Charles Tampis | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-24 |
| 1164033445 | Alexandra Demascole | Social Worker | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-11 |
| 1386254498 | Krishna Rana | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| 1730799842 | Jinah Han | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
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| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982920336 | Lisa Jane Hannah Cichon | Pathology | 7250 Nc Highway 751 Apt 1109, Durham, NC 27707-5720 | 2010-04-09 |
| 1699876102 | David Noble Howell | Pathology | 3712 Pathology, Duke University Medical Center, Durham, NC 27710-0001 | 2006-09-26 |
| 1154647949 | Amanda Carolyn Hemmerich | Pathology | 2301 Erwin Rd, Durham, NC 27710-6437 | 2010-04-19 |
| 1538332903 | Anne F Buckley | Pathology | 1000 Trent Drive, Durham, NC 27710-0001 | 2008-04-08 |
| 1497841878 | Victor Louis Roggli | Pathology | 1000 Trent Drive, Durham, NC 27710-0001 | 2006-10-05 |
| 1013009042 | Jane Taylor Gaede | Pathology | 508 Fulton St, Section 113, Durham, NC 27705-3875 | 2006-09-28 |
| 1114962313 | Maria A Selim | Pathology | Erwin Rd, Durham, NC 27710-0001 | 2006-06-19 |
| 1063405793 | Laura Barisoni-thomas | Pathology | 40 Duke Medicine Cir, Durham, NC 27710-1005 | 2005-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356835789 | Peters Pathology, LLC | Pathology | 302 Lindsay St Fl 2, High Point, NC 27262-4961 | 2018-06-19 |
| 1497118608 | David A Eberhard | Pathology | 105 E Poplar Ave, Carrboro, NC 27510-1709 | 2016-04-04 |
| 1609133313 | Alexei Vladimirovitch Mikhailov | Pathology | Medical Center Blvd Department of Pathology, Winston Salem, NC 27157-0001 | 2012-04-19 |
| 1801849351 | Tara C Rubinas | Pathology | 101manning Dr, Chapel Hill, NC 27599-0001 | 2006-05-18 |
| 1952379083 | Susan M Ferrell | Pathology | 272 Newstock Road, Asheville, NC 28804 | 2006-03-14 |
| 1639155971 | Dell Andrew Dembosky | Pathology | 30 Page St., Pinehurst, NC 28374-8449 | 2005-12-19 |
| 1497739866 | Venkata Ramana Challa | Pathology | 507 N Lindsay St, High Point, NC 27262-4303 | 2005-11-30 |
| 1275096497 | Madiha Emran Soofi | Pathology | 600 Moye Blvd, Greenville, NC 27834-4300 | 2019-04-14 |
| 1093112385 | Adil Gasim | Pathology | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2014-12-02 |
| 1285053959 | William Harrison | Pathology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2014-04-10 |
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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.