NPIMap

Individual provider Active NPI

Amanda L Shoemaker, MD

  • Family Medicine Physician
  • Holt, MI
National Provider Identifier
1235354804
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301084697 Issued in MI
Practice address
2040 N. Aurelius Rd
Ste 22
Holt, MI 48842-1594
Phone
(517) 694-2217
NPI assigned
Apr 17, 2007
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301084697 MI Primary

Addresses

Primary practice location

2040 N. Aurelius Rd
Ste 22
Holt, MI 48842-1594

Mailing address

2040 N. Aurelius Rd
Ste 22
Holt, MI 48842-1594
Phone (517) 694-2217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071015000101 MI Practitioner - Family Practice 6608962196 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
460 Sparrow Regional Children's Center
Lansing, MI 48912-1897
Phone (517) 364-5490

2040 Aurelius Rd
Holt, MI 48842-1367
Phone (517) 694-2217

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301084697MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Jan 1, 2025 Accepting new patients
Sparrow Ionia Hospital Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Sparrow Carson Hospital CurrentSince Jan 1, 2025 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Oct 1, 2007 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Sparrow Ionia Hospital Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Interoperability endpoints

  • Direct secure messaging: ashoemaker1575@sparrowdirecthie.org

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1235354804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 N. AURELIUS RD",
            "address_2": "STE 22",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421594",
            "telephone_number": "517-694-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 N. AURELIUS RD",
            "address_2": "STE 22",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421594",
            "telephone_number": "517-694-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301084697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

Verify at the official NPI Registry.