Active NPI
Gregory Shonk, RN
- Administrator Registered Nurse
- Macomb, MI
National Provider Identifier
1306255096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 4704191620
- Practice address
- 18526 London Dr
Macomb, MI 48042-6216 - Phone
- (586) 615-5662
- NPI assigned
- Aug 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 4704191620 | MI | Primary |
Addresses
Primary practice location
18526 London Dr
Macomb, MI 48042-6216
Mailing address
18526 London Dr
Macomb, MI 48042-6216
Phone (586) 615-5662
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704191620 | MI | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1306255096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18526 LONDON DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480426216",
"telephone_number": "586-615-5662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18526 LONDON DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480426216",
"telephone_number": "586-615-5662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHONK",
"first_name": "GREGORY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-06",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "MI",
"license": "4704191620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.