Veronica Shivachi, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704245731 Issued in MI

Practice address

24110 Meadowbrook Rd
Suite 206
Novi, MI 48375-3459

Phone

(888) 707-5716

Fax

(888) 707-5716

NPI assigned

Sep 29, 2010

Last updated

Apr 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1699084343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24110 MEADOWBROOK RD",
            "address_2": "SUITE 206",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753459",
            "telephone_number": "888-707-5716",
            "fax_number": "888-707-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24110 MEADOWBROOK RD",
            "address_2": "SUITE 206",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753459",
            "telephone_number": "888-707-5716",
            "fax_number": "888-707-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVACHI",
        "first_name": "VERONICA",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704245731",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704245731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699084343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Novi, MI
• Providers in Novi, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.