Donna M Shull, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004955 Issued in MI

Practice address

804 Service Road
Room A142
East Lansing, MI 48824-7039

Phone

(517) 353-3050

Fax

(517) 432-3742

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan State University

  • Local Education Agency (LEA)
  • East Lansing, MI
  • NPI 1184182982
  NPD (past)
• Edmonds Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1336181676
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1396864559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 WABANINGO RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644405",
            "telephone_number": "517-349-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE ROAD",
            "address_2": "ROOM A142",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247039",
            "telephone_number": "517-353-3050",
            "fax_number": "517-432-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Shivers
• Ustina Treber Shives, MA LPC
• David A Shneider, M.D.
• Ginger Marie Shrader, PMHNP
• Jolene Elyse Shrewsberry-Gardner
• Shuptar Speech Therapy, LLC
• Ericka A Shuptar, M.S., CCC-SLP
• Jonathan David Shy, LLP
• Lindelwe Nkazimulo Sibanda
• Antonio Siciliano, LMSW

• Physician Assistant in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.