MR. SHANE SPEAKER (LMSW) – Clinical Social Worker, NPI 1164995684

MR. SHANE SPEAKER (LMSW) is a healthcare provider. based in Coldwater, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801094324 (MI). The NPI Number for MR. SHANE SPEAKER (LMSW) is 1164995684

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. SHANE SPEAKER (LMSW)
NPI
1164995684
Phone
(517) 278-2129
Address
200 VISTA DR
Enumeration Date
8 January 2019
Last Update Date
8 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5172782129
Graduation Year
2012 (14 years ago)
PAC ID
1153668413
Group Practice PAC ID
4789612714
Professional Enrollment ID
I20190124000144
Address ID
MI490361776CO200XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:7State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for MR. SHANE SPEAKER (LMSW)

  • 200, Vista Drive, Coldwater, Branch County, Michigan, 49036, United States

    COLDWATER, MI 490361776

    Phone: (517) 278-2129

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190124000144IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49036)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789612714View full group profile
NameSpecialtyState
Clinical Social WorkerMI
P S Y C H I A T R YMI
P S Y C H I A T R YWV
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Nurse PractitionerMI
P S Y C H I A T R YMI
P S Y C H I A T R YMI
P S Y C H I A T R YMI

Reviews

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Frequently asked questions

Where can patients find MR. SHANE SPEAKER (LMSW)'s NPI?
You can confirm MR. SHANE SPEAKER (LMSW) with NPI 1164995684; it appears in the national provider directory.
Is MR. SHANE SPEAKER (LMSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MR. SHANE SPEAKER (LMSW)'s specialty in plain language?
Clinically, the directory lists MR. SHANE SPEAKER (LMSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does MR. SHANE SPEAKER (LMSW) practice in Michigan?
You will see Coldwater, Michigan on file for MR. SHANE SPEAKER (LMSW) alongside any extra practice locations.
What if Coldwater, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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