Healthcare Provider Details

I. General information

NPI: 1114188323
Provider Name (Legal Business Name): MELISSA JOY SHELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 SKEET CLUB RD STE 112
HIGH POINT NC
27265-9530
US

IV. Provider business mailing address

4907 SHADY PINE DR
GREENSBORO NC
27455-1515
US

V. Phone/Fax

Practice location:
  • Phone: 336-883-0029
  • Fax: 336-883-0867
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number0010-09540
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-09540
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: