Individual provider Active NPI

Melissa Shimshock, FNP-C

  • Family Nurse Practitioner
  • Sandusky, MI
National Provider Identifier
1215432927
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704234651 Issued in MI
Practice address
109 N Delaware St
Sandusky, MI 48471-1008
Phone
(810) 648-9677
Fax
(810) 648-0053
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 4704234651 MI Primary

Addresses

Primary practice location

109 N Delaware St
Sandusky, MI 48471-1008

Mailing address

120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-3770

Other practice location 1

7307 Cherry St
Port Sanilac, MI 48469-9621
Phone (810) 622-9248

Other practice location 2

36555 26 Mile Rd Ste 1100
Lenox, MI 48048-3186
Phone (947) 523-4010

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address melissa.shimshock@mhs.eclinicaldirectplus.com
Direct Messaging Address mshimshock5139907@direct.beaumont.edu

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
I20180403001342 MI Practitioner - Nurse Practitioner 2466714431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Nov 21, 2022 Accepting new patients

Locations

36555 26 Mile Rd
Ste 1100
Lenox, MI 48048
Phone (947) 523-4010

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: mshimshock1255733@epic00.shdirect.org

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1215432927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711009",
            "telephone_number": "810-648-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711008",
            "telephone_number": "810-648-9677",
            "fax_number": "810-648-0053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7307 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Port Sanilac",
            "state": "MI",
            "postal_code": "484699621",
            "country_code": "US",
            "telephone_number": "810-622-9248",
            "fax_number": "810-622-8276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36555 26 Mile Rd Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Lenox",
            "state": "MI",
            "postal_code": "480483186",
            "country_code": "US",
            "telephone_number": "947-523-4010",
            "fax_number": "947-523-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMSHOCK",
        "first_name": "MELISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704234651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa.shimshock@mhs.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "109 N Delaware St",
            "city": "Sandusky",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484711008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshimshock5139907@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "36555 26 Mile Rd Ste 1100",
            "city": "Lenox",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480483186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

Verify at the official NPI Registry.