Individual provider Active NPI

Heather Lyn Shahan, CNS

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Kent, OH
National Provider Identifier
1144467754
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
NS 08110 Issued in OH
Practice address
5982 Rhodes Rd
Kent, OH 44240-4128
Phone
(330) 673-1347
Fax
(330) 678-3677
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X RN 268915 OH
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X NS 08110 OH Primary

Addresses

Primary practice location

5982 Rhodes Rd
Kent, OH 44240-4128

Mailing address

5982 Rhodes Rd
Kent, OH 44240-4128
Phone (330) 673-1347

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
I20050309000252 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 5698729093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coleman Professional Services, Inc.Group PAC ID 2769474618, 64 clinicians

Practice addresses (Care Compare)

3920 Lovers LN
Ravenna, OH 44266-4200
Phone (330) 673-1347

3922 Lovers LN
Ravenna, OH 44266-4200
Phone (330) 673-1347

5982 Rhodes Rd
Kent, OH 44240-8100
Phone (330) 673-1347

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NS 08110OHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist
RN 268915OHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Professional Services, Inc. CurrentSince Sep 13, 2011 Accepting new patients
Turning Point Counseling Services, Inc. Past Accepting new patients
Community Support Services, Inc. Past Accepting new patients
Compass Family and Community Services Past Accepting new patients

Locations

400 Tuscarawas St W
Ste 200
Canton, OH 44702
Phone (330) 438-1724

5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875

3920 Lovers Ln
Ravenna, OH 44266
Phone (330) 676-8051

611 Belmont Ave
Youngstown, OH 44502
Phone (330) 744-2991

Organizations & group practices 4

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1144467754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAN",
        "first_name": "HEATHER",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "RN 268915",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "NS 08110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.