Individual provider Active NPI

Brittany Shamoun

  • Nurse Practitioner
  • Troy, MI
National Provider Identifier
1053848614
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704295819 Issued in MI
Practice address
44201 Dequindre Rd Ste Ec
Troy, MI 48085-1117
Phone
(248) 964-5111
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704295819 MI
Nurse Practitioner 363L00000X 4704295819 MI Primary

Addresses

Primary practice location

44201 Dequindre Rd Ste Ec
Troy, MI 48085-1117

Mailing address

7305 Village Park Dr
Clarkston, MI 48346-1994

Other practice location 1

7305 Village Park Dr
Clarkston, MI 48346-1994
Phone (248) 563-9524

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bshamoun957546@direct.beaumont.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170920003098 MI Practitioner - Nurse Practitioner 6608140207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704295819MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orion Family Physicians PC CurrentSince Aug 6, 2017 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince May 1, 2019 Accepting new patients

Locations

1455 S Lapeer Rd
Ste 100
Lake Orion, MI 48360
Phone (248) 693-3551

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

44201 Dequindre Rd
Ste Ec
Troy, MI 48085
Phone (248) 259-3088

Interoperability endpoints

  • Direct secure messaging: bshamoun1255467@epic00.shdirect.org
  • Direct secure messaging: bshamoun957546@direct.beaumont.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1053848614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 VILLAGE PARK DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD STE EC",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7305 Village Park Dr",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483461994",
            "country_code": "US",
            "telephone_number": "248-563-9524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMOUN",
        "first_name": "BRITTANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704295819",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704295819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bshamoun957546@direct.beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "44201 Dequindre Rd Ste Ec",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.