Active NPI
Shane David Monroe
- Acupuncturist
- Grand Rapids, MI
National Provider Identifier
1710521877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 5401000225
- Practice address
- 3355 Eagle Park Dr NE Ste 108
Grand Rapids, MI 49525-7004 - Phone
- (707) 342-7333
- NPI assigned
- Nov 1, 2019
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 5401000225 | MI | Primary |
Addresses
Primary practice location
3355 Eagle Park Dr NE Ste 108
Grand Rapids, MI 49525-7004
Mailing address
1025 Arianna St NW
Grand Rapids, MI 49504-3050
Phone (707) 342-7333
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5401000225 | MI | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1710521877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 ARIANNA ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495043050",
"telephone_number": "707-342-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3355 EAGLE PARK DR NE STE 108",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495257004",
"telephone_number": "707-342-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONROE",
"first_name": "SHANE",
"middle_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-01",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MI",
"license": "5401000225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.