Shelly Nickel

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3727 Wilder Rd
Bay City, MI 48706-2367

Phone

(989) 980-9747

Fax

(888) 527-3589

NPI assigned

Oct 15, 2018

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)

Not enrolled

Practice roles

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.

• Game Changer Pediatric Therapy Services LLC

  • Pediatric Occupational Therapist
  • Bay City, MI
  • NPI 1437506383
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1871069161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 MICHIGAN RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069313",
            "telephone_number": "989-980-9747",
            "fax_number": "888-527-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 WILDER RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062367",
            "telephone_number": "989-980-9747",
            "fax_number": "888-527-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "SHELLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Christopher Newton, O.D.
• Elizabeth Ann Neymeiyer, M.A. L.P.C.
• Viet Han Huu Nguyen, AU.D.
• Niche Aging Center
• Kiley Nichol, OTRL
• Darcy Nickless
• Holly Nickless, OT
• Brock David Niernberg
• Rachel Colleen Nikolai, MSOT, OTRL
• Heather Lyn Nitcher, RDH

• Behavior Technician in Bay City, MI
• Providers in Bay City, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.