Stacy Lee Shelly, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704261939 Issued in MI

Practice address

414 S Burdick St
Ste. 200
Kalamazoo, MI 49007-6219

Phone

(269) 381-4446

Fax

(269) 381-4457

NPI assigned

Apr 26, 2012

Last updated

Apr 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Case Management of Michigan, Inc.

  • Case Management Agency
  • Kalamazoo, MI
  • NPI 1043286537
  NPD (past)

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1801154927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S BURDICK ST",
            "address_2": "STE. 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490076219",
            "telephone_number": "269-381-4446",
            "fax_number": "269-381-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S BURDICK ST",
            "address_2": "STE. 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490076219",
            "telephone_number": "269-381-4446",
            "fax_number": "269-381-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "STACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704261939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suhail Sheikh, M.D.
• Michael A Shelden, DO
• Steven Frederick Shelden, D.O,
• Shamanthika Shelkay, MD
• Guy Clinton Shelley IV, MD
• Paula Marie Shelner, LMSW
• Dewayne Shelton
• Tyra Shepherd
• Robert J. Sheppard, PHD
• Frederick Sherburn, DO

• Registered Nurse in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.