Elizabeth Shark, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601001454 Issued in MI

Practice address

15520 19 Mile Rd Ste 450
Clinton TWP, MI 48038-6332

Phone

(586) 416-2000

Fax

(586) 416-2013

NPI assigned

Oct 13, 2015

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

Other identifiers 1

Other names 1

• Elizabeth Landa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1407227689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15520 19 MILE RD STE 450",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386332",
            "telephone_number": "586-416-2000",
            "fax_number": "586-416-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARK",
        "first_name": "ELIZABETH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "2601001454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sensory Technology Services, Inc
• Brian M Shaeffer, DC
• Heba Shakouri, PHARMD
• Selma P Shamass, PHARMACIST BS
• Karen Sue Shannon-Wilson, MSOTRL
• Enkeleda Shehu
• Carol Ann Sherwood, PTA, COTAL
• Robert W Shick Jr., OD
• Raymond Shin, D.C.
• Shishir Senapati MD PC

• Athletic Trainer in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.