Individual provider Active NPI

Shannon Christine Nemeth, M.S., PT

  • Physical Therapist
  • Kingsley, MI
National Provider Identifier
1902340508
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010903 Issued in MI
Practice address
4040 Beacon St
Kingsley, MI 49649-9548
Phone
(231) 263-1350
Fax
(231) 263-1353
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010903 MI Primary

Addresses

Primary practice location

4040 Beacon St
Kingsley, MI 49649-9548

Mailing address

4040 Beacon St
Kingsley, MI 49649-9548
Phone (231) 263-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926000845 MI Practitioner - Physical Therapist in Private Practice 9234480526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tmi East IncGroup PAC ID 3274864665, 62 clinicians

Practice addresses (Care Compare)

1725 Port Sheldon St
Jenison, MI 49428-9002
Phone (810) 701-4633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Tmi East, Inc. CurrentSince Aug 5, 2025 Accepting new patients
Vitality at Home Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Lighthouse, Inc. Past Accepting new patients

Locations

1725 Port Sheldon St
Jenison, MI 49428
Phone (616) 667-1725

851 Penniman Ave
Plymouth, MI 48170
Phone (248) 349-9595

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": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1902340508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BEACON ST",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499548",
            "telephone_number": "231-263-1350",
            "fax_number": "231-263-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BEACON ST",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499548",
            "telephone_number": "231-263-1350",
            "fax_number": "231-263-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMETH",
        "first_name": "SHANNON",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.S., PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.