Individual provider Active NPI

Melissa Shafer

  • Acute Care Nurse Practitioner
  • Grand Blanc, MI
National Provider Identifier
1194488155
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704255738 Issued in MI
Practice address
1 Genesys Pkwy Ste 3512
Grand Blanc, MI 48439-8065
Phone
(801) 606-7550
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704255738 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy Ste 3512
Grand Blanc, MI 48439-8065

Mailing address

9519 Pere Marquette Dr
Grand Blanc, MI 48439-8316
Phone (810) 471-8807

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
I20211124000865 MI Practitioner - Nurse Practitioner 9133519671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesys Practice Partners IncGroup PAC ID 3476456492, 37 clinicians

Practice addresses (Care Compare)

3615 Genesys Pkwy
Grand Blanc, MI 48439-8070
Phone (810) 606-7500

Hospital & facility affiliations

  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesys Practice Partners Inc CurrentSince Oct 1, 2021 Accepting new patients
Genesys Practice Partners Inc Current Accepting new patients
Genesys Practice Partners, Inc CurrentSince Oct 1, 2021 Accepting new patients
Mymichigan Medical Center Saginaw Current Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients

Locations

1460 N Center Rd
Burton, MI 48509
Phone (810) 424-2011

3399 Pollock Rd
Ste A
Grand Blanc, MI 48439
Phone (810) 606-7550

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1 Genesys Pkwy
Ste 3615
Grand Blanc, MI 48439

3615 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-6891

1 Genesys Pkwy
Ste 4620
Grand Blanc, MI 48439
Phone (810) 606-1460

1 Genesys Pkwy
Ste 3512
Grand Blanc, MI 48439
Phone (801) 606-7550

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3570 Shattuck Rd
Saginaw, MI 48603
Phone (989) 792-5353

Interoperability endpoints

  • Direct secure messaging: mshafer1150882@direct.hfhs.org
  • Direct secure messaging: melissa.shafer.1@8209.direct.athenahealth.com

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 1

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1194488155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9519 PERE MARQUETTE DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398316",
            "telephone_number": "810-471-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY STE 3512",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "801-606-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704255738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.