Individual provider Active NPI

Shanae Ramona Williams, PA-C

  • Physician Assistant
  • Flint, MI
National Provider Identifier
1780577783
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4466 W Bristol Rd
Flint, MI 48507-3170
Phone
(810) 733-1200
Fax
(810) 733-0688
NPI assigned
May 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4466 W Bristol Rd
Flint, MI 48507-3170

Mailing address

4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 733-1200

Other practice location 1

17015 Silver Pkwy
Fenton, MI 48430-3425
Phone (810) 593-0023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814000631 MI Practitioner - Physician Assistant 9739687120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17015 Silver Pkwy
Fenton, MI 48430-3425
Phone (810) 593-0023

4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 733-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Orthopedic Associates P L C Physician Assistant CurrentSince Aug 4, 2025 Accepting new patients
Family Orthopedic Associates P L C Physician Assistant CurrentSince Aug 4, 2025 Accepting new patients

Locations

17015 Silver Pkwy
Fenton, MI 48430
Phone (810) 593-0023

4466 W Bristol Rd
Flint, MI 48507
Phone (810) 733-1200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1780577783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17015 Silver Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484303425",
            "country_code": "US",
            "telephone_number": "810-593-0023",
            "fax_number": "810-593-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANAE",
        "middle_name": "RAMONA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.