Individual provider Active NPI

Shauna Joy Richey, FNP-BC

  • Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1285381152
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F12210656 Issued in MI
Practice address
555 Graystone
Traverse City, MI 49686-7901
Phone
(231) 620-4171
NPI assigned
Mar 9, 2022
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F12210656 MI Primary

Addresses

Primary practice location

555 Graystone
Traverse City, MI 49686-7901

Mailing address

555 Graystone
Traverse City, MI 49686-7901
Phone (231) 620-4171

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
I20220901002053 MI Practitioner - Nurse Practitioner 3173907680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

331 Meadows Dr
Grayling, MI 49738-2016
Phone (989) 348-2801

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F12210656MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Jun 10, 2025 Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

331 Meadows Dr
Grayling, MI 49738
Phone (989) 348-2801

2280 Tower Hill Rd
Houghton Lake, MI 48629
Phone (989) 422-5153

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1285381152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 GRAYSTONE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496867901",
            "telephone_number": "231-620-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 GRAYSTONE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496867901",
            "telephone_number": "231-620-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHEY",
        "first_name": "SHAUNA",
        "middle_name": "JOY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "F12210656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.