Individual provider Active NPI

Shelley Marie Drew, D.O.

  • Family Medicine Physician
  • Walker, MI
National Provider Identifier
1679536726
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SD010173 Issued in MI
Practice address
1550 3 Mile Rd NW
Walker, MI 49544-8251
Phone
(616) 785-3883
NPI assigned
Apr 10, 2006
Last updated
Nov 1, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SD010173 MI Primary

Addresses

Primary practice location

1550 3 Mile Rd NW
Walker, MI 49544-8251

Mailing address

1550 3 Mile Rd NW
Walker, MI 49544-8251
Phone (616) 785-3883

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110602000639 MI Practitioner - Family Practice 0840191235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Family Medicine PCGroup PAC ID 9133020514, 6 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

1550 3 Mile NW Rd a
Walker, MI 49544-8251
Phone (616) 785-3883

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
SD010173MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Family Medicine PC Family Medicine CurrentSince Mar 6, 1999 Accepting new patients
West Michigan Family Medicine-Kentwood, PLC Family Medicine PastSince Mar 6, 1999 Accepting new patients

Locations

2120 43rd St SE
Ste 200
Kentwood, MI 49508
Phone (616) 455-4114

1550 3 Mile Rd NW
Walker, MI 49544
Phone (616) 455-4114

1550 3 Mile Rd NW
Ste A
Walker, MI 49544
Phone (616) 785-3883

Interoperability endpoints

  • Direct secure messaging: sdrew1860@epic00.corewelldirect.org

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1679536726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 3 MILE RD NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495448251",
            "telephone_number": "616-785-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 3 MILE RD NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495448251",
            "telephone_number": "616-785-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "SHELLEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "SD010173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walker, MI

Sources for this page

Verify at the official NPI Registry.