NPIMap

Individual provider Active NPI

Shamelle White

  • Pediatrics Physician
  • Grand Rapids, MI
National Provider Identifier
1073869590
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301101356 Issued in MI
Practice address
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone
(616) 391-8810
Fax
(616) 391-8897
NPI assigned
Aug 2, 2012
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301101356 MI Primary

Addresses

Primary practice location

275 Michigan St NE
Grand Rapids, MI 49503-2531

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address swhite117263@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921000308 MI Practitioner - Pediatric Medicine 7416264643 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health United CurrentSince Nov 2, 2020 Accepting new patients
Mecosta County Medical Center CurrentSince Apr 1, 2021 Accepting new patients
Mecosta County Medical Center Pediatrics CurrentSince Apr 1, 2021 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
Spectrum Health United CurrentSince Nov 2, 2020 Accepting new patients
Pennock Hospital CurrentSince Apr 1, 2021 Accepting new patients
Spectrum Health Hospitals CurrentSince Sep 14, 2015 Accepting new patients
Pennock Hospital CurrentSince Apr 1, 2021 Accepting new patients
Spectrum Health Hospitals CurrentSince Sep 14, 2015 Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

330 Barclay Ave NE
Ste 300
Wyoming, MI 49503
Phone (616) 391-8806

Interoperability endpoints

  • Direct secure messaging: swhite117263@epic00.corewelldirect.org
  • Direct secure messaging: swhite61525@direct.hfhs.org

Organizations & group practices 9

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": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1073869590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032531",
            "telephone_number": "616-391-8810",
            "fax_number": "616-391-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHAMELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301101356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swhite117263@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "330 Barclay Ave NE",
            "address_2": "Suite 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "330 Barclay Ave NE",
            "address_2": "Suite 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.