Organization Active NPI

Shontae L Howard

  • Family Nurse Practitioner
  • Englewood, OH
National Provider Identifier
1003685934
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SHONTAE L HOWARD
Practice address
12 W Wenger Rd Ste J
Englewood, OH 45322-2755
Phone
(937) 529-8085
NPI assigned
Dec 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shontae HowardNPI 1255531315
Title
Owner
Phone
(937) 529-8085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

12 W Wenger Rd Ste J
Englewood, OH 45322-2755

Mailing address

12 W Wenger Rd Ste J
Englewood, OH 45322-2755
Phone (937) 529-8085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240419002099 OH Part B Supplier - Clinic/Group Practice 4981043114 Receives reassigned benefits from 1 practitioner
Practice locations: Englewood, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1003685934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W WENGER RD STE J",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222755",
            "telephone_number": "937-529-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W WENGER RD STE J",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222755",
            "telephone_number": "937-529-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHONTAE L HOWARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SHONTAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-529-8085"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.