Individual provider Active NPI

Brian Shetler

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1225394356
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
680195685 Issued in MI
Practice address
500 Hancock Street
Saginaw, MI 48602-4224
Phone
(989) 797-3400
Fax
(989) 799-0206
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 680195685 MI Primary

Addresses

Primary practice location

500 Hancock Street
Saginaw, MI 48602-4224

Mailing address

500 Hancock Street
Saginaw, MI 48602-4224
Phone (989) 797-3400

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170327001492 MI Practitioner - Clinical Social Worker 5698050052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

40 W Saginaw Rd
Mymichigan Family Medicine
Sanford, MI 48657-9206
Phone (989) 687-9940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
680195685MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince May 9, 2022 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 9, 2022 Accepting new patients

Locations

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

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

40 W Saginaw Rd
Sanford, MI 48657
Phone (855) 507-3299

Organizations & group practices 2

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 3

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1225394356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HANCOCK STREET",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HANCOCK STREET",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETLER",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680195685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.