Shanley Brooke Shelburne, PA-C is a medicare enrolled "Physician Assistant - Medical" in Pennington Gap, Virginia. Her current practice location is
1800 Combs Rd, Suite 7, Pennington Gap, Virginia. You can reach out to her office (for appointments etc.) via phone at
(276) 546-4894.
Shanley Brooke Shelburne is licensed to practice in Virginia (license number 0110-005327) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679927123.
Provider's Profile
Full Name | Shanley Brooke Shelburne |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 1800 Combs Rd, Pennington Gap, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1679927123
- Provider Enumeration Date: 04/21/2016
- Last Update Date: 05/04/2017
Medicare PECOS Information:
- PECOS PAC ID: 4284926924
- Enrollment ID: I20170605000024
Medical Identifiers
Medical identifiers for Shanley Brooke Shelburne such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679927123 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 0110-005327 (Virginia) | Primary |
363AM0700X | Physician Assistant - Medical | TC481 (Kentucky) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shanley Brooke Shelburne is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shanley Brooke Shelburne, PA-C 41830 E Morgan Ave Ste 202, Pennington Gap, VA 24277-3218 Ph: (336) 512-3162 | Shanley Brooke Shelburne, PA-C 1800 Combs Rd, Suite 7, Pennington Gap, VA 24277-1808 Ph: (276) 546-4894 |
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