Individual provider Active NPI

Nichole Paige Shriver, APRN, CNP

  • Family Nurse Practitioner
  • Mount Vernon, OH
National Provider Identifier
1114742095
Registry record updated Dec 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0038120 Issued in OH
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050-1495
Phone
(740) 393-4325
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0038120 OH Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050-1495

Mailing address

12952 State Route 39
Big Prairie, OH 44611-9682
Phone (330) 473-9619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250217002321 OH Practitioner - Nurse Practitioner 7618497918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

1451 Yauger Rd
Suite 1C
Mount Vernon, OH 43050-7904
Phone (740) 393-4325

Hospital & facility affiliations

  • Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
  • Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0038120OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Mar 3, 2025 Accepting new patients
Knox Community Hospital CurrentSince Mar 3, 2025 Accepting new patients

Locations

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1114742095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12952 STATE ROUTE 39",
            "city": "BIG PRAIRIE",
            "state": "OH",
            "postal_code": "446119682",
            "telephone_number": "330-473-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501495",
            "telephone_number": "740-393-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "NICHOLE",
        "middle_name": "PAIGE",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0038120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.