Active NPI
Joel M Shavell, DO
- Rheumatology Physician
- Dearborn, MI
National Provider Identifier
1346296951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 5101006280
- Practice address
- 5050 Schaefer Rd
Dearborn, MI 48126-3249 - Phone
- (313) 581-2600
- Fax
- (313) 581-0228
- NPI assigned
- May 25, 2006
- Last updated
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 5101006280 | MI | Primary |
Addresses
Primary practice location
5050 Schaefer Rd
Dearborn, MI 48126-3249
Mailing address
6754 Timber Ridge Dr
Bloomfield Hills, MI 48301-3064
Phone (248) 855-2450
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114590774 | Medicaid | MI | |
| 5730686 | Other | MI | AETNA |
| 110Q262840 | Other | MI | BCBSM/BCN |
| 50930 | Other | MI | OMNICARE HEALTH PLAN |
| 023777 | Other | MI | MIDWEST HEALTH PLAN |
| 236661 | Other | MI | MEDICARE PROVIDER NO |
| 5823027 | Other | MI | MEDICARE PROVIDER NO. |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1346296951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6754 TIMBER RIDGE DR",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483013064",
"telephone_number": "248-855-2450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 SCHAEFER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263249",
"telephone_number": "313-581-2600",
"fax_number": "313-581-0228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVELL",
"first_name": "JOEL",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MI",
"license": "5101006280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114590774",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5730686",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM/BCN",
"identifier": "110Q262840",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMNICARE HEALTH PLAN",
"identifier": "50930",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "023777",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NO",
"identifier": "236661",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NO.",
"identifier": "5823027",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.