Shane Kelleher, PA-C
Shane Kelleher, PA-C is a Physician Assistant in Fort Worth, TX, registered under NPI 1003273939.
Getting there
The practice address on file is 1500 COOPER ST, Fort Worth, TX 76104. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| PA105592 | TX | Physician Assistant primary |
| 2628 | OK | Physician Assistant |
Licences are recorded in 2 states: TX, OK. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
Licensed in 2 states
This provider holds licences in 2 states: Oklahoma and Texas. The practice address on file is in Fort Worth, TX, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Physician Assistant covers
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. NUCC Health Care Provider Taxonomy, code 363A00000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA105592 | TX | primary |
| 363A00000X | Physician Assistant | 2628 | OK |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1003273939 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jan 22, 2016 |
| Last updated | Aug 2, 2016 |
| Status | Active |
| Sole proprietor | No |
| Credential | PA-C |
| Practice address |
1500 COOPER ST Fort Worth, TX 76104 (682) 885-7840 Fax (682) 885-7856 |
| Mailing address |
PO BOX 99371 Fort Worth, TX 76199 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 2 | 7 | 3 | 9 | 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 4 | 7 | 6 | 9 | 6 |
Sum = 61 · next multiple of 10 = 70 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.