Individual provider Active NPI

Shawn R Roberson, DNP

  • Nurse Practitioner
  • Saginaw, MI
National Provider Identifier
1174955066
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704274764 Issued in MI
Practice address
3160 Cabaret TRL S
Saginaw, MI 48603-2202
Phone
(989) 799-8712
Fax
(989) 791-4216
NPI assigned
Aug 2, 2013
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704274764 MI Primary

Addresses

Primary practice location

3160 Cabaret TRL S
Saginaw, MI 48603-2202

Mailing address

PO Box 373
Otisville, MI 48463-0373
Phone (989) 272-9580

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sroberson36431@direct.covenanthealthcare.com

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
I20131029000222 MI Practitioner - Nurse Practitioner 3476788449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Clinic Neurosurgery PLLCGroup PAC ID 5496989337, 2 clinicians

Practice addresses (Care Compare)

3160 Cabaret TRL S
Saginaw, MI 48603-2202
Phone (989) 799-8712

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.69 of 100Reported as group
Quality
86.67
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Clinic Neurosurgery PLLC CurrentSince Oct 4, 2014 Accepting new patients

Locations

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

4675 Hill St
Ste B
Cass City, MI 48726
Phone (989) 912-6112

3160 Cabaret Trl S
Saginaw, MI 48603
Phone (989) 799-8712

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1174955066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "OTISVILLE",
            "state": "MI",
            "postal_code": "484630373",
            "telephone_number": "989-272-9580",
            "fax_number": "989-272-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 CABARET TRL S",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032202",
            "telephone_number": "989-799-8712",
            "fax_number": "989-791-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "SHAWN",
        "middle_name": "R",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704274764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sroberson36431@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "3160 Cabaret Trl S",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486032202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.