Individual provider Active NPI

Meghna Shukla, CPNP

  • Pediatric Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1235649963
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704289843 Issued in MI
Practice address
Children'S Hospital of Mi
3901 Beaubien
Detroit, MI 48201
Phone
(313) 745-5260
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704289843 MI Primary
Nurse Practitioner 363L00000X 4704289843 MI

Addresses

Primary practice location

Children'S Hospital of Mi
3901 Beaubien
Detroit, MI 48201

Mailing address

University Pediatricians
4201 St. Antoine - Uhc 5D Mailbox 226
Detroit, MI 48201-2153
Phone (313) 745-4405

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
I20171102003299 MI Practitioner - Nurse Practitioner 5294091575 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Psychiatric Services, P.L.C. CurrentSince Oct 1, 2023 Accepting new patients
Bloom Pediatrics PC PastSince Aug 2, 2020 Accepting new patients

Locations

20010 Farmington Rd
Livonia, MI 48152
Phone (248) 471-7171

Organizations & group practices 3

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1235649963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY PEDIATRICIANS",
            "address_2": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HOSPITAL OF MI",
            "address_2": "3901 BEAUBIEN",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "MEGHNA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704289843",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704289843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.