Active NPI
Peter Kenneth Shireman, MD
- Anatomic Pathology & Clinical Pathology Physician
- Muskegon, MI
National Provider Identifier
1740220052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 4301050218
- Practice address
- 1774 Peck St
Muskegon, MI 49441-2533 - Phone
- (231) 728-5758
- Fax
- (231) 728-5636
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 4301050218 | MI | Primary |
Addresses
Primary practice location
1774 Peck St
Muskegon, MI 49441-2533
Mailing address
3967 Norton Hills Rd
Norton Shores, MI 49441-4456
Phone (231) 780-3236
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1543841 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | drpete77@comcast.net | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301050218 | MI | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1740220052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3967 NORTON HILLS RD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494414456",
"telephone_number": "231-780-3236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1774 PECK ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494412533",
"telephone_number": "231-728-5758",
"fax_number": "231-728-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIREMAN",
"first_name": "PETER",
"middle_name": "KENNETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MI",
"license": "4301050218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1543841",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "drpete77@comcast.net",
"affiliation": "N",
"endpointDescription": "Mercy Muskegon Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "1774 Peck St",
"city": "Muskegon",
"state": "MI",
"country_code": "US",
"postal_code": "494412533",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.