Shelby Petersen
Physician Assistant · Grand Rapids, MI
Shelby Petersen is a physician assistant with a practice address in Grand Rapids, Michigan, and NPI 1245006709, issued on Nov 27, 2023. Check the license (Michigan 5601012426, as entered in NPPES) with the Michigan board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Shelby Petersen
- Primary taxonomy
- Physician Assistant 363A00000X
- License number
- 5601012426 MI
Self-reported in NPPES; status is on the state search - Practice location
- 4100 Embassy Dr SE Ste 400, Grand Rapids, MI 49546
- Phone
- (822) 061-6988
- Enumerated
- Nov 27, 2023
- Record last updated
- Jul 22, 2024
- Medicare enrollment
- Enrolled (PECOS I20241003001263); accepts Medicare assignment
- Medical or professional school
- Wayne State University School Of Medicine, 2024
- Entity
- Type 1 · individual
8 nearest physician assistant records → All 6,989 in Michigan → Look up another NPI →
Also registered at 4100 Embassy Dr SE Ste 400
A shared address usually means a shared clinic or building; it does not show who employs whom.
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- Rebecca Cline, PA-CPhysician Assistant1194203240
- Alexandra Faasse, PA-CPhysician Assistant1871275776
- Lydia Fales, PA-CPhysician Assistant1962116962
- Stephanie Flohr, RNRegistered Nurse1164277356
- Nicholas Frame, M.D.Emergency Medicine Physician1104230341
Verify Shelby Petersen in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Michigan board licenses this profession
Search for license 5601012426Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Ecs Western Michigan PCHastings, MI
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Shelby Petersen among 6,989 physician assistant records in Michigan
Shelby Petersen is one of 6,989 physician assistant records with a practice address in Michigan. 82% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2023, is newer than 80% of them.
- NPI issued2023 · 80% of these records are older, 14% newer
- In a Medicare fileYes · 82% of these records are
- In the CMS Doctors and Clinicians fileYes · 68% of these records are
- Graduated2024 · median 2017 among the 4,739 with a school on file
- Record last updated2024 · 40% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363A00000X and a Michigan practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
913 physician assistant records list a practice address in Grand Rapids
They are 913 of the 18,005 NPPES records with a practice address in Grand Rapids, and 6,989 physician assistant records in Michigan.
All 6,989 in Michigan → Every provider in Grand Rapids → Physician Assistant nationwide →
The 8 physician assistant records with the nearest ZIP codes
- Randall Brady, PAGrand Rapids, MI 495461396798542
- Robert Burghduf, PA-CGrand Rapids, MI 495461477548832
- Heather Dickinson, PA-CGrand Rapids, MI 495461144269291
- Karen Garbowitz, PA-CGrand Rapids, MI 495461144210139
- Patrick Handlin, PAGrand Rapids, MI 495461366421711
- Kendra Lowing, P.A.Grand Rapids, MI 495461710951488
- Kathryn Pleune, PA-CGrand Rapids, MI 495461467426122
- Karen Ruihley, PA-CGrand Rapids, MI 495461225094295
Common questions
What is Shelby Petersen's NPI number?
Shelby Petersen's National Provider Identifier (NPI) is 1245006709, issued on Nov 27, 2023. An NPI identifies a provider in billing; it is not a license.
Where is Shelby Petersen located?
The NPPES record lists a practice address at 4100 Embassy Dr SE Ste 400, Grand Rapids, MI, 49546. Phone: (822) 061-6988. Providers update this record themselves, so call before visiting.
How can I verify Shelby Petersen's license?
NPPES lists Michigan license number 5601012426, as entered by the provider. Search the Michigan board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.