Jeffery Everett Shively

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

12007 Linwood St
Detroit, MI 48206-1107

Phone

(313) 867-1090

NPI assigned

Jan 28, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1750771747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 CHARTERHOUSE CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881520",
            "telephone_number": "734-625-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 LINWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061107",
            "telephone_number": "313-867-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "JEFFERY",
        "middle_name": "EVERETT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-28",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayvon Larnard Shipman, LMSW - CLINICAL
• Shirley Care Agency LLC
• Antonia Nicole Shirley, BSW
• Dyshinique Shirley
• Hazel Shively, LLMSW
• Shivkumar Prabhu, M.D., P.C.
• Khulood Shkookani Alqous, MD
• Oladayo Davidson Shobola, MD
• Nakeisha Ramon Shockley
• Naja Yahya Shohatee

• Case Manager/Care Coordinator in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.