Individual provider Active NPI

Shelly Jane Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Rapids, MI
National Provider Identifier
1679689707
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704223822 Issued in MI
Practice address
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone
(616) 364-4200
Fax
(616) 364-7347
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704223822 MI Primary

Addresses

Primary practice location

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Other practice location 1

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-2000 ext. 32400

Other identifiers 1

IdentifierTypeStateIssuer
4688421MedicaidMI

Other names 1

  • Shelly J Peplinski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050215000534 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385629484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Mary'S Health Services 175 clinicians
Anesthesia Medical Consultants, PC 87 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (734) 263-2400

4055 Cascade Rd SE
Metro Health Park East Outpatient Surgical
Grand Rapids, MI 49546-2149
Phone (616) 364-4200

5900 Byron Ctr Ave SW
Metro Health Hospital
Wyoming, MI 49519-9606
Phone (616) 364-4200

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Mary'S Health Services Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients
Anesthesia Medical Consultants, PC CurrentSince Jul 28, 2011 Accepting new patients
Saint Mary'S Health Services CurrentSince Nov 1, 2025 Accepting new patients

Locations

3333 Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 284-3132

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grand Oaks Nursing CenterBaldwin, MI, CCN 235499 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10%) Jan 1, 2012
North Woods Nursing CenterFarwell, MI, CCN 235464 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10%)
Adp of the SNF
Jan 1, 2012
Jan 1, 2012
Maple Woods ManorClio, MI, CCN 235518 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (6.67%) Jan 1, 2012
West Woods of NilesNiles, MI, CCN 235594 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10%)
Adp of the SNF
Jan 1, 2012
Jan 1, 2012
Huron Woods Nursing CenterKawkawlin, MI, CCN 235592 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10%)
Adp of the SNF
Jan 1, 2012
Jan 1, 2012
West Hickory HavenMilford, MI, CCN 235262 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10%)
Adp of the SNF
Jan 1, 2012
Jan 1, 2012
West Woods of BridgmanBridgman, MI, CCN 235625 Skilled nursing facility Adp of the SNF Jan 1, 2012

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1679689707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Sherman Blvd",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494441849",
            "country_code": "US",
            "telephone_number": "231-672-2000 x32400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHELLY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704223822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4688421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "PEPLINSKI",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.