Individual provider Active NPI

Lana Shishlo, CNP

  • Family Nurse Practitioner
  • Gahanna, OH
National Provider Identifier
1205409869
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LE-00037609 Issued in OH
Practice address
453 Waterbury CT
Gahanna, OH 43230-5309
Phone
(614) 515-5244
Fax
(614) 515-5244
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 377505 OH
Family Nurse Practitioner 363LF0000X LE-00037609 OH Primary

Addresses

Primary practice location

453 Waterbury CT
Gahanna, OH 43230-5309

Mailing address

9030 Pringle Benjamin Rd
London, OH 43140-8870
Phone (614) 657-5226

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
I20240409001527 OH Order and Referring Only - Nurse Practitioner 7911345079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
377505OHMDRegistered Nurse
LE-00037609OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vakolane Home Healthcare, LLC CurrentSince Jul 25, 2021 Accepting new patients
Columbus Integrative Family Medicine Center LLC CurrentSince Jul 25, 2021 Accepting new patients

Locations

453 Waterbury Ct
Gahanna, OH 43230
Phone (614) 381-9795

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1205409869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 PRINGLE BENJAMIN RD",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431408870",
            "telephone_number": "614-657-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 WATERBURY CT",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305309",
            "telephone_number": "614-515-5244",
            "fax_number": "614-515-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISHLO",
        "first_name": "LANA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2022-05-19",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "377505",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "LE-00037609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.