Individual provider Active NPI

Elizabeth Carri Shanks

  • Family Nurse Practitioner
  • Stanton, MI
National Provider Identifier
1184508095
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704355149 Issued in MI
Practice address
1124 E Pakes Rd
Stanton, MI 48888-9276
Phone
(616) 255-7683
Fax
(616) 255-7683
NPI assigned
Aug 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704355149 MI Primary

Addresses

Primary practice location

1124 E Pakes Rd
Stanton, MI 48888-9276

Mailing address

1124 E Pakes Rd
Stanton, MI 48888-9276
Phone (616) 255-7683

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
I20260424001533 MI Practitioner - Nurse Practitioner 1658848833 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians
Mymichigan Medical Center ClareGroup PAC ID 7012829773, 128 clinicians

Practice addresses (Care Compare)

1469 Mary CT
Alma, MI 48801-1053
Phone (989) 629-8215

602 Beech St
Clare, MI 48617-1466
Phone (989) 802-5117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704355149MIMDFamily Nurse Practitioner

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1184508095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E PAKES RD",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889276",
            "telephone_number": "616-255-7683",
            "fax_number": "616-255-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E PAKES RD",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889276",
            "telephone_number": "616-255-7683",
            "fax_number": "616-255-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "ELIZABETH",
        "middle_name": "CARRI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704355149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanton, MI

Sources for this page

Verify at the official NPI Registry.