Individual provider Active NPI

Shelley Ostric, MD

  • Family Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1063388965
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301513066 Issued in MI
Practice address
326 N. Ferry St.
Grand Haven, MI 49417
Phone
(616) 846-2701
Fax
(616) 846-8009
NPI assigned
Oct 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301513066 MI Primary

Addresses

Primary practice location

326 N. Ferry St.
Grand Haven, MI 49417

Mailing address

326 N. Ferry St.
Grand Haven, MI 49417
Phone (616) 846-2701

Other names 1

  • Shelley Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301513066MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Love Inc of the Tri-Cities PastSince Oct 21, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15079/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1063388965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N. FERRY ST.",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-846-2701",
            "fax_number": "616-846-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 N. FERRY ST.",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-846-2701",
            "fax_number": "616-846-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTRIC",
        "first_name": "SHELLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301513066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "JACKSON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.