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Shawna Davella Dietrick

Physician • Romulus, MI

Active NPI 1154955219 Individual Practitioner Female Practitioner
Practice location in NPPES

35675 Garner St
Romulus, MI 481744129

Call 8103087991 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

35675 Garner St

Romulus, MI 481744129

Telephone 8103087991
Organization at the Same NPPES Address or Phone
Gracious By Your Side Llc Facility NPI 1346996287

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-02-27
Respite Care - Respite Care, Physical Disabilities, Child Primary Specialty

NUCC Taxonomy Code: 385HR2065X

License # reported to NPPES MI D362765135841

A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Identification
D362765135841 (MI)

Career & Practice History

NPI enumerated February 27, 2020.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from March 2020 to November 2026.

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NPI Administrative Meta

NPI Number: 1154955219
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 27, 2020
Last Update: February 27, 2020
Sole Proprietor: Yes

Mailing Address

Po Box 74083

Romulus, MI 481740083

Phone: 8103087991

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.