Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

SHALETTA NUCKOLLS PA-C
NPI 1568083426
Physician Assistant in Ann Arbor, MI

Active since May 02, 2020PECOS EnrolledAccepts Medicare Assignment
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109(734) 936-4000 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 10, 2026, Mar 7, 2024, Mar 7, 2021 and 7 more (10 updates tracked since 2020).

About Shaletta Nuckolls Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHALETTA NUCKOLLS PA-C (NPI 1568083426) is an individual physician assistant in Ann Arbor, Michigan, licensed in Michigan (5601009964) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and maintains a secondary practice location in West Bloomfield.

NPPES Registry Identity

NPI1568083426
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHALETTA NUCKOLLSCredential: PA-C
Location Address1500 E MEDICAL CENTER DRAnn Arbor, MI 48109-5000
Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 2, 2020
Last NPPES UpdateJuly 10, 202610 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
NPI 1568083426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601009964
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109

Secondary Practice Location 1

Location 16777 W Maple RdWest Bloomfield, MI 48322-3013 · Phone (248) 325-1000

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shaletta Nuckolls Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880018092
PECOS Enrollment IDI20200721003334
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist (Pharmacotherapy)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Psychiatry & Neurology (Psychiatry)
1500 E MEDICAL CENTER DR, B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY
ANN ARBOR, MI 48109
Nurse Practitioner
1500 E MEDICAL CENTER DR, 3RD FLOOR TAUBMAN CENTER RECP D
ANN ARBOR, MI 48109
Nurse Practitioner
1500 E MEDICAL CENTER DR, 3RD TAUBMAN CENTER RECP A
ANN ARBOR, MI 48109
Internal Medicine (Gastroenterology)
1500 E MEDICAL CENTER DR, 3RD FLOOR TAUBMAN CENTER RECP D
ANN ARBOR, MI 48109
Radiology (Diagnostic Radiology)
1500 E MEDICAL CENTER DR, B1 FLOOR UNIVERSITY HOSPITAL RECP C
ANN ARBOR, MI 48109
Nurse Anesthetist, Certified Registered
1500 E MEDICAL CENTER DR, 1ST FLOOR TAUBMAN CENTER RECP E
ANN ARBOR, MI 48109
Nurse Anesthetist, Certified Registered
1500 E MEDICAL CENTER DR, 1H247 UNIVERSITY HOSPITAL
ANN ARBOR, MI 48109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shaletta Nuckolls's NPI number?

The NPI number for Shaletta Nuckolls is 1568083426. It was assigned to this individual provider in the NPPES registry on May 2, 2020.

Where is Shaletta Nuckolls located?

Shaletta Nuckolls practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.

What is Shaletta Nuckolls's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Shaletta Nuckolls enrolled in Medicare?

Yes. Shaletta Nuckolls is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shaletta Nuckolls accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and McLaren Health Plan Community list Shaletta Nuckolls as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shaletta Nuckolls affiliated with any hospitals?

According to CMS data, Shaletta Nuckolls is affiliated with Henry Ford Health Hospital.

When was this NPI record last updated?

The NPPES record for Shaletta Nuckolls was last updated on July 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.