Prachi Shukla, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467

Phone

(586) 582-6630

Fax

(586) 582-6631

NPI assigned

Apr 12, 2022

Last updated

Apr 12, 2022By the provider in NPPES

Sex

Female

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

Enrolled in MI, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Detroit Macomb-Oakland Hospital Corporation

  dba Macomb Hospital Academic Medical Group

  • Internal Medicine Physician
  • Warren, MI
  • NPI 1699969782
  NPD (past)
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD (past)

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1215679899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD STE 300A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933467",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD STE 300A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933467",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "PRACHI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lynn Showerman, O.T.R
• Cole James Showers, DO
• Angel Shrader
• Jayashree Shreeganesh, DDS
• Charnetta Shufford
• Yogesh J Shukla, MD
• Siddhi Corp (Rapid Pharmacy)
• Naveed Siddique, MD
• Salah Siddiqui, DO
• Sierra Pride Home Healthcare Agency LLC (Tom the Tailor)

• Student in an Organized Health Care Education/Training Program in Warren, MI
• Providers in Warren, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.