DR. JACK CHARLES SHELTON (NPI# 1942316476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942316476 |
| Entity Type | Individual |
| Full Name | DR. JACK CHARLES SHELTON |
| Credential | M.D. |
| Practice Address |
4708 Alliance Blvd Ste 300 Baylor Medical Plaza 1 Plano TX 75093-5339 |
| Practice Telephone | 9727586000 |
| Practice Fax Number | 9727586001 |
| Mailing Telephone | 9727586000 |
| Mailing Fax Number | 9727586001 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D5205 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 115119302 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184617227 | Jack Barnett Shelton Jr. | Pathology | 2800 10th Ave S Ste 2200, Hospital Pathology Assoc, Minneapolis, MN 55407-1311 | 2005-08-24 |
| Street Address |
4708 ALLIANCE BLVD STE 300 BAYLOR MEDICAL PLAZA 1 |
| City | PLANO |
| State | TX |
| Zip Code | 75093-5339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578676664 | Paul Kenneth Anderson | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-16 |
| 1629401252 | Sarah Katherine Wuollet | Physician Assistant | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2013-08-19 |
| 1427376250 | Uzma Ahmad | Psychiatry & Neurology | 4708 Alliance Blvd Ste 300, Plano, TX 75093-5339 | 2010-05-04 |
| 1922275098 | Mahenaaz Haq | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2008-05-08 |
| 1366650772 | Christina Jean Kuo | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2007-05-18 |
| 1154423911 | Jeffrey Claypool Lilly | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-09-02 |
| 1992811335 | Rick Talley Waldo | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-21 |
| 1477669992 | Mark David Thieberg | Dermatology | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-21 |
| 1881709376 | Joseph Herman Sample | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-21 |
| 1962518431 | Jeff Earl Taylor | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789041 | Mapleshade Surgery Center, LLC | Clinic/Center | 960 Ohio Dr, Plano, TX 75093 | 2019-09-13 |
| 1003461468 | Psyclear, LLC | Psychologist | 5055 West Park Boulevard, Suite 400, Plano, TX 75093 | 2019-08-02 |
| 1962981795 | Ep Anesthesia Pllc | Anesthesiology | 4100 Mapleshade Ln, Plano, TX 75093 | 2018-08-13 |
| 1669973939 | Eva Walekhwa | Registered Nurse | 6000 Ohio Drive, Apt 1027, Plano, TX 75093 | 2018-02-22 |
| 1437657624 | Advanced Spine Center | Orthopaedic Surgery | 1705 Ohio Drive, Suite 300, Plano, TX 75093 | 2018-01-23 |
| 1184139974 | Erica Cherese Carey | Nurse Practitioner | 1100 Allied Drive, Plano, TX 75093 | 2017-12-04 |
| 1457865578 | Norma Vigilant | Specialist/Technologist, Other | 4909 West Park Blvd, Plaza Park Salons, Plano, TX 75093 | 2017-11-28 |
| 1891214011 | Americare Rx Pharmacy Inc | Pharmacy | 4010 W. 15th St., Ste 60, Plano, TX 75093 | 2017-09-19 |
| 1760912554 | Baylor Surgicare At Baylor Plano, LLC | Clinic/Center | 4825 Alliance, Sute 300, Plano, TX 75093 | 2017-06-14 |
| 1881133262 | Dr.seshagiri Rao | Preferred Provider Organization | 3016 Communications Pkwy, Ste 100, Plano, TX 75093 | 2017-02-17 |
| Find all providers in zip 75093 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902399926 | Your Health Diagnostics LLC | Internal Medicine | 5228 Village Creek Dr Ste 101, Plano, TX 75093-4431 | 2018-06-13 |
| 1821543208 | Vitality Weight Loss and Wellness Institute, Pllc | Internal Medicine | 2633 Dallas Pkwy # 100, Plano, TX 75093-4703 | 2016-08-16 |
| 1609230812 | Ebony N. Raymond | Internal Medicine | 3105 W 15th St Ste E, Plano, TX 75075 | 2016-04-13 |
| 1386008167 | Love Wounds | Internal Medicine | 4416 Jenkins Dr, Plano, TX 75024-4817 | 2016-04-07 |
| 1578942546 | Omniphysicians, Pllc | Internal Medicine | 3000 Custer Rd Ste 270-507, Plano, TX 75075-4422 | 2015-05-24 |
| 1285022491 | Slalani Medico Service Pllc | Internal Medicine | 3408 Westwind Dr, Plano, TX 75093-7987 | 2014-12-23 |
| 1689062879 | Lone Medical Mht LLC | Internal Medicine | 1925 Edgewater Dr, Plano, TX 75075-8573 | 2014-12-23 |
| 1700283280 | Texas On Call Physicians PC | Internal Medicine | 3213 Twinfalls Dr, Plano, TX 75093-3331 | 2014-11-26 |
| 1487066114 | Pablo Andres Wunderlich Padilla | Internal Medicine | 4700 Alliance Blvd Ste 100, Plano, TX 75093-5323 | 2014-05-29 |
| 1629496336 | Tawfik A. Shabana | Internal Medicine | 4317 High Mesa Dr, Plano, TX 75093 | 2014-03-31 |
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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.