Individual provider Active NPI

Yuan Shang, NP

  • Family Nurse Practitioner
  • Caledonia, MI
National Provider Identifier
1821544123
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704321387 Issued in MI
Practice address
10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone
(616) 685-8850
NPI assigned
Aug 28, 2016
Last updated
Mar 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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 4704321387 MI Primary

Addresses

Primary practice location

10047 Crossroad CT SE
Caledonia, MI 49316-7316

Mailing address

3640 Bridgehampton Dr NE
Grand Rapids, MI 49546-1445
Phone (877) 906-9699

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
I20160929001730 MI Practitioner - Nurse Practitioner 2466749700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Care Solutions for Adults and Seniors IncGroup PAC ID 4880918051, 71 clinicians

Practice addresses (Care Compare)

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704321387MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Nurse Practitioner CurrentSince May 1, 2024 Accepting new patients
Behavioral Care Solutions for Adults and Seniors, Inc. Adult Health CurrentSince Dec 12, 2023 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince May 1, 2024 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

39465 W 14 Mile Rd
Novi, MI 48377
Phone 24885939000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1821544123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 BRIDGEHAMPTON DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461445",
            "telephone_number": "877-906-9699",
            "fax_number": "888-483-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10047 CROSSROAD CT SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167316",
            "telephone_number": "616-685-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANG",
        "first_name": "YUAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704321387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

Verify at the official NPI Registry.