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

Shane Charles Wilson, DO

Individual provider Internal Medicine Physician · NPI 1477808467

Shane Charles Wilson, DO is an Internal Medicine in Memphis, Missouri. Graduated from At Still University, Arizona School of Dentistry & Oral Hlth in 2012, 14 years ago. Practices with Northeast Missouri Health Council Inc, a 20-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
14
Trained at
At Still University, Arizona School of Dentistry & Oral Hlth
Licensed in
MO
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

118 E Grand Ave
Memphis, MO 63555-1419
Phone: (660) 465-7522
Fax: (660) 465-7526
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2014026613 (MO)

Record details

NPI number1477808467
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 17, 2012
Last updated in NPPESMay 8, 2026
Certification dateMay 8, 2026
Mailing address118 E Grand Ave, Memphis, MO 63555-1419

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolAT STILL UNIVERSITY, ARIZONA SCHOOL OF DENTISTRY & ORAL HLTH
Graduated 2012 (14 years in practice)
Group practice Northeast Missouri Health Council Inc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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