Individual provider Active NPI

Shelby Mackenzie Stapleton Rogers

  • Addiction (Substance Use Disorder) Counselor
  • Hamilton, OH
National Provider Identifier
1053193151
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
186088 Issued in OH
Practice address
8500 Bilstein Blvd
Hamilton, OH 45015-2218
Phone
(856) 439-6111
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 186088 OH Primary

Addresses

Primary practice location

8500 Bilstein Blvd
Hamilton, OH 45015-2218

Mailing address

1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
186088OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-Xiii, LLC CurrentSince Oct 22, 2023 Accepting new patients

Locations

1317 Route 73
Ste 200
Mount Laurel, NJ 08054
Phone (856) 439-6111

8500 Bilstein Blvd
Hamilton, OH 45015
Phone (513) 275-4273

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1053193151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 BILSTEIN BLVD",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450152218",
            "telephone_number": "856-439-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON ROGERS",
        "first_name": "SHELBY",
        "middle_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "186088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.