Kelsi Shea, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704354629 Issued in MI

Practice address

400 Johnson St
Alpena, MI 49707-1434

Phone

(989) 354-2515

NPI assigned

Feb 12, 2020

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Northeast Michigan Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Alpena, MI
  • NPI 1144378381
  NPD
• Northeast Michigan Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Alpena, MI
  • NPI 1508180662
  NPD (past)

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1215569751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20095 COUNTY ROAD 451",
            "city": "HILLMAN",
            "state": "MI",
            "postal_code": "497469532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-354-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "KELSI",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704354629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Lawrence Secrest, D.D.S.
• Alex Senchuk, PHARMD
• April Senchuk
• McKenna Sharp
• Cassandra Shaw, LLMSW
• Hassan Sam Sheikho, MD
• Nicole Katherine Shepherd, CHW
• Meredith Haar Sheridan, D.D.S.
• Stephen Clovis Sheridan, M.D.
• Tara Lee Sherman, MPT

• Registered Nurse in Alpena, MI
• Providers in Alpena, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.