Shawn Randall Prentice

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

15221 State Route 772
Piketon, OH 45661-9062

Phone

(937) 213-0416

NPI assigned

Jul 13, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pike County Recovery Council Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waverly, OH
  • NPI 1760742993
  NPD (past)

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1043796980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 7TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624518",
            "telephone_number": "937-213-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15221 STATE ROUTE 772",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619062",
            "telephone_number": "937-213-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "SHAWN",
        "middle_name": "RANDALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piketon Facility Operations, LLC
• Piketon Nursing Center LLC
• Pleasant Hill Leasing, LLC
• Melisa Lynn Ponder
• Portsmouth Emergency Ambulance Service Inc
• Coralee Priest
• Brandon M Privitera, DDS
• Macy Puckett
• Seth Queen, QMHS
• Quest Diagnostics

• Addiction (Substance Use Disorder) Counselor in Piketon, OH
• Providers in Piketon, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.