Shauna Brianne Wishka, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005795 Issued in MI

Practice address

12330 James St
H-10
Holland, MI 49424-8689

Phone

(616) 582-3100

NPI assigned

Jul 28, 2010

Last updated

Jan 16, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1770897084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443720",
            "telephone_number": "231-733-8679",
            "fax_number": "231-733-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 JAMES ST",
            "address_2": "H-10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248689",
            "telephone_number": "616-582-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHKA",
        "first_name": "SHAUNA",
        "middle_name": "BRIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillips H Winter, M.D.
• Sara Winter, LMSW
• William B Winter, P.T.
• Jonathan Winters, PHARMD, MBA
• Michelle Anne Wis
• Duane Frank Wisk, D.O.
• Erin Wisniewski, FNP-C
• Philip C Wisniewski, DDS, FAGD, PC
• Jennie L Woehl, FNP
• Benjamin Woiwode, M.ED, BCBA

• Physician Assistant in Holland, MI
• Providers in Holland, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.