Individual provider Active NPI

Shelby Brewington, PA-C

  • Physician Assistant
  • Bloomfield Hills, MI
National Provider Identifier
1104381847
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4050 W Maple Rd Ste 101
Bloomfield Hills, MI 48301-3118
Phone
(248) 885-8211
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI Primary

Addresses

Primary practice location

4050 W Maple Rd Ste 101
Bloomfield Hills, MI 48301-3118

Mailing address

21395 Waverly Dr
Macomb, MI 48044-1863

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

Practice roles

OrganizationSpecialtyStatusNew patients
A3 Medical CurrentSince Oct 16, 2022 Accepting new patients

Locations

4050 W Maple Rd
Ste 101
Bloomfld Hls, MI 48301
Phone (248) 385-3412

Interoperability endpoints

  • Direct secure messaging: shelbybrewington@emcuramed.allscriptsdirect.net

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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1104381847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21395 WAVERLY DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 W MAPLE RD STE 101",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013118",
            "telephone_number": "248-885-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWINGTON",
        "first_name": "SHELBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.