Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miranda Shelly

Individual provider Physician Assistant · NPI 1679270706

Miranda Shelly is a Physician Assistant in Richmond, Virginia. Qualified in 2022, 4 years ago. Practices with Gastrointestinal Specialists LLC, a 79-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
4
Licensed in
VA
In the registry since
2023
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Practice location Address checks out

6602 W Broad St Ste B
Richmond, VA 23230-1702
Phone: (804) 285-8206
Fax: (804) 497-5469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110009160 (VA)

Record details

NPI number1679270706
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 9, 2023
Last updated in NPPESAugust 28, 2023
Certification dateAugust 28, 2023
Mailing addressPo Box 8310, Roanoke, VA 24014-0310

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Gastrointestinal Specialists Llc — 79 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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