Shelby Petersen
NPI 1245006709 · Physician Assistant · Grand Rapids, MI
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shelby Petersen is a Physician Assistant provider in Grand Rapids, MI (NPI 1245006709).
Provider details
- NPI number
- 1245006709
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 5601012426 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-11-27
- Last updated
- 2024-07-22
- Certified
- 2024-07-17
Frequently asked questions
- What is Shelby Petersen's NPI number?
- Shelby Petersen's National Provider Identifier (NPI) is 1245006709, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shelby Petersen's specialty?
- Shelby Petersen is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shelby Petersen located?
- Shelby Petersen's practice location on file with NPPES is 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416.
- What is Shelby Petersen's phone number?
- The practice phone number listed in the NPPES registry for Shelby Petersen is (822) 061-6988.
- Does Shelby Petersen accept Medicare?
- Shelby Petersen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shelby Petersen's NPI active?
- Yes — Shelby Petersen's NPI (1245006709) is active in the NPPES registry as of the last update on 2024-07-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.