Active NPI
SHC Medical Partners of Michigan, LLC
- Nurse Practitioner
- Livonia, MI
National Provider Identifier
1316648587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- SHC MEDICAL PARTNERS OF MICHIGAN, LLC
- Practice address
- 28550 Five Mile Rd
Livonia, MI 48154-3866 - Phone
- (734) 427-8270
- NPI assigned
- Mar 15, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angie Mattingly
- Title
- MGR Provider Enrollment
- Phone
- (502) 630-7425
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
28550 Five Mile Rd
Livonia, MI 48154-3866
Mailing address
805 N Whittington Pkwy
Louisville, KY 40222-7101
Phone (502) 630-7425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Canton, MI
- NPI 1821647108
-
- Family Nurse Practitioner
- Taylor, MI
- NPI 1508221409
-
- Geriatric Medicine (Internal Medicine) Physician
- Louisville, KY
- NPI 1174516751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779148800000",
"number": "1316648587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 N WHITTINGTON PKWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402227101",
"telephone_number": "502-630-7425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28550 FIVE MILE RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481543866",
"telephone_number": "734-427-8270"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHC MEDICAL PARTNERS OF MICHIGAN, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-15",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A",
"authorized_official_last_name": "MATTINGLY",
"authorized_official_first_name": "ANGIE",
"authorized_official_title_or_position": "MGR PROVIDER ENROLLMENT",
"authorized_official_telephone_number": "502-630-7425"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.