Active NPI
Jacob Shane
- Personal Care Attendant
- Dearborn Heights, MI
National Provider Identifier
1497699706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 4907 Kingston St
Dearborn Heights, MI 48125-3243 - Phone
- (313) 450-5573
- NPI assigned
- Apr 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
4907 Kingston St
Dearborn Heights, MI 48125-3243
Mailing address
4907 Kingston St
Dearborn Heights, MI 48125-3243
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1497699706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4907 KINGSTON ST",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481253243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4907 KINGSTON ST",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481253243",
"telephone_number": "313-450-5573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANE",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-16",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.