Active NPI
Shannon Prince
- Home Health Aide
- Canal Winchester, OH
National Provider Identifier
1164782199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 3651880
- Practice address
- 6722 Kristins Cove LN
Canal Winchester, OH 43110-8683 - Phone
- (614) 500-1642
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 3651880 | OH | Primary |
| Nurse's Aide | 376K00000X | 401391190512 | OH |
Addresses
Primary practice location
6722 Kristins Cove LN
Canal Winchester, OH 43110-8683
Mailing address
400 Daner Rd
Columbus, OH 43213-3489
Phone (614) 864-5818
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3651880 | OH | MD | Personal Care Attendant |
| 401391190512 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337731200000",
"number": "1164782199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 DANER RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432133489",
"telephone_number": "614-864-5818",
"fax_number": "614-866-9203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6722 KRISTINS COVE LN",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431108683",
"telephone_number": "614-500-1642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINCE",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-23",
"last_updated": "2012-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "3651880",
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "401391190512",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canal Winchester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.