Individual provider Active NPI

Shayna M. Pettini, AUD

  • Audiologist
  • Wheeling, WV
National Provider Identifier
1174906044
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-0322 Issued in WV
Practice address
1 Medical Park
Wheeling, WV 26003-6379
Phone
(304) 243-3000
Fax
(304) 243-3060
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01974 OH
Audiologist 231H00000X A-0322 WV Primary

Addresses

Primary practice location

1 Medical Park
Wheeling, WV 26003-6379

Mailing address

1 Medical Park
Wheeling, WV 26003-6379
Phone (304) 243-3000

Other names 1

  • Shayna M. Goode Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A01974OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital, Inc. Past Accepting new patients

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1174906044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036379",
            "telephone_number": "304-243-3000",
            "fax_number": "304-243-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036379",
            "telephone_number": "304-243-3000",
            "fax_number": "304-243-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINI",
        "first_name": "SHAYNA",
        "middle_name": "M.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01974",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A-0322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYNA",
            "last_name": "GOODE",
            "middle_name": "M.",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.