Individual provider Active NPI

Shelley McLain, RN

  • Registered Nurse
  • Saint Clair Shores, MI
National Provider Identifier
1235650615
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704141120 Issued in MI
Practice address
23409 Jefferson Ave Ste 102
Saint Clair Shores, MI 48080-3449
Phone
(586) 204-9060
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704141120 MI Primary

Addresses

Primary practice location

23409 Jefferson Ave Ste 102
Saint Clair Shores, MI 48080-3449

Mailing address

23409 Jefferson Ave Ste 102
Saint Clair Shores, MI 48080-3449
Phone (586) 204-9060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704141120MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Able Hearts Care LLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

23409 Jefferson Ave
Ste 102
Saint Clair Shores, MI 48080
Phone (586) 204-9060

Organizations & group practices 1

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235650615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23409 JEFFERSON AVE STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803449",
            "telephone_number": "586-204-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23409 JEFFERSON AVE STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803449",
            "telephone_number": "586-204-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAIN",
        "first_name": "SHELLEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704141120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.