Shelby Jackson

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

17920 Winsome
Fraser, MI 48026-3168

Phone

(313) 422-5832

NPI assigned

Nov 15, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1003681560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40583 CANTERBURY DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480387120",
            "telephone_number": "586-873-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 WINSOME",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263168",
            "telephone_number": "313-422-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Hyman, MA
• Abigail Ignagni, PA-C
• Behram Irani, MD
• MD Remaul Islam
• Ryan M Jaber, M.D.
• Patricia Ann Janas, BCBA
• John a. Breza DDS PC
• Pamela Anne Jostock, M.D.
• Edward Kakish, DO
• Lindsay L Kalinowski, PA-C

• Home Health Aide in Fraser, MI
• Providers in Fraser, MI by specialty
• Home Health Aide in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.