Individual provider Active NPI

Shelby Lee Payne, FNP

  • Family Nurse Practitioner
  • Owosso, MI
National Provider Identifier
1801500558
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704286178 Issued in MI
Practice address
200 N Caledonia Dr
Owosso, MI 48867-8844
Phone
(989) 729-4848
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704286178 MI Primary

Addresses

Primary practice location

200 N Caledonia Dr
Owosso, MI 48867-8844

Mailing address

501 Lapeer Ave
Saginaw, MI 48607-1203
Phone (989) 753-6000

Other identifiers 1

IdentifierTypeStateIssuer
000000000OtherMIFNP

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
I20240126003395 MI Practitioner - Nurse Practitioner 3779936687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704286178MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Dec 22, 2023 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Dec 22, 2023 Accepting new patients

Locations

200 N Caledonia Dr
Owosso, MI 48867
Phone (989) 729-4848

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

Interoperability endpoints

  • Direct secure messaging: shelby.payne.1@27771.direct.athenahealth.com

Organizations & group practices 2

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1801500558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-753-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N CALEDONIA DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488678844",
            "telephone_number": "989-729-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "SHELBY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-01-11",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704286178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP",
            "identifier": "000000000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.