Individual provider Active NPI

Shanetha Betts, NP

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1437349172
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704232658 Issued in MI
Practice address
7430 2ND Ave
Suite 210
Detroit, MI 48202-2739
Phone
(313) 748-4200
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704232658 MI Primary

Addresses

Primary practice location

7430 2ND Ave
Suite 210
Detroit, MI 48202-2739

Mailing address

7430 2ND Ave
Suite 210
Detroit, MI 48202-2739
Phone (313) 748-4200

Other names 1

  • Shanetha Livingston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080119000065 MI Practitioner - Nurse Practitioner 8426139122 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704232658MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Nurse Practitioner CurrentSince Apr 1, 2023 Accepting new patients
Bronson Methodist Hospital Family CurrentSince Jun 1, 2016 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Dec 25, 2024 Accepting new patients
Hills & Dales General Hospital, Inc. Current Accepting new patients
TLC of Mi LLC Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

400 Renaissance Ctr
Ste 2600
Detroit, MI 48243
Phone (248) 599-1582

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

29800 Hoover Rd
Warren, MI 48093
Phone (586) 574-3444

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Interoperability endpoints

  • Direct secure messaging: slivington412160@direct.hfhs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1437349172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7430 2ND AVE",
            "address_2": "SUITE 210",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022739",
            "telephone_number": "313-748-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7430 2ND AVE",
            "address_2": "SUITE 210",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022739",
            "telephone_number": "313-748-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTS",
        "first_name": "SHANETHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704232658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANETHA",
            "last_name": "LIVINGSTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.