Melisa Michelle Shafer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501010588 Issued in MI

Practice address

69045 M 62
Edwardsburg, MI 49112-9150

Phone

(269) 663-2201

NPI assigned

Aug 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Baker-Johnson Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Arizona Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Peoria, AZ
  • NPI 1629698147
  Medicare reassignment NPD

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

{
    "created_epoch": "1534550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534550400000",
    "number": "1730669714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67236 HESS RD",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69045 M 62",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129150",
            "telephone_number": "269-663-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "MELISA",
        "middle_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-18",
        "last_updated": "2018-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BAKER-JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexander Moskalow
• Ontwa Jefferson Mason Milton Calvin Tnshps & Village of Edwardsburg
• Regional Home Care of Michigan Inc
• Samar and Ranya Inc
• Gina Schade, IHP
• Katie Smith, LCSW
• Southwest Vision Center Inc.
• Haylie Rebecca Stevenson
• Aranella Dionisio Villaluz, PT, PTA, MOH
• Von Carlo Viaje Villaluz, PT

• Physical Therapist in Edwardsburg, MI
• Providers in Edwardsburg, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.