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General NPI Number Information
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NPI Number | 1881770451
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Entity Type | Individual
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Provider Name | JASON SCOTT SHELLHAAS MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1 BROOKINGS DR
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City | SAINT LOUIS
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State | MO
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Zip | 63130-4862
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Country | US
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Telephone | 314-935-6666
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Fax | 314-696-1214
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Provider Business Mailing Address
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Address Line | 1 BROOKINGS DRIVE MSC 1201-323-100
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City | ST LOUIS
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State | MO
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Zip | 63130-4899
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Country | US
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Telephone | 314-935-6666
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Fax | 314-696-1214
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | 2022043202
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2022043202
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License Number State | MO
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