Individual provider Active NPI

Shanelle Johnson

  • Doula
  • Southfield, MI
National Provider Identifier
1295540698
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
17515 W 9 Mile Rd Ste 200
Southfield, MI 48075-4404
Phone
(248) 943-2891
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X MI Primary

Addresses

Primary practice location

17515 W 9 Mile Rd Ste 200
Southfield, MI 48075-4404

Mailing address

24762 Ashley CT
Redford, MI 48239-2623
Phone (248) 943-2891

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1295540698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24762 ASHLEY CT",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392623",
            "telephone_number": "248-943-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17515 W 9 MILE RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754404",
            "telephone_number": "248-943-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.