Jeremy B Shelley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016143 Issued in MI

Practice address

7040 Red Arrow Hwy
Coloma, MI 49038

Phone

(269) 468-4318

Fax

(269) 468-6269

NPI assigned

Nov 27, 2018

Last updated

Nov 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Hospital

  dba Community Hospital OP Rehabilition

  • Rehabilitation Hospital Unit
  • Coloma, MI
  • NPI 1124298021
  NPD (past)
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • Rural Health Clinic/Center
  • Dowagiac, MI
  • NPI 1184467607
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1194295782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 RED ARROW HWY",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "49038",
            "telephone_number": "269-468-4318",
            "fax_number": "269-468-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 RED ARROW HWY",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "49038",
            "telephone_number": "269-468-4318",
            "fax_number": "269-468-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "JEREMY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanna R Rodgers, MA
• Jaime Rodriguez, M.D.
• Ruth Lee Center for Healing and Growth
• Shafee Ahamad Shaik
• Melinda Amber Shannon, PT. DPT, MS
• Faith Shreve, LMSW
• Southwest Michigan Center for Orthopaedics and Sports Medicine
• Southwest Michigan Home Care Services, Inc
• Ashley R Stacker, LMSW
• Startup Center for Inner Peace, PLLC

• Physical Therapist in Coloma, MI
• Providers in Coloma, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.