Addie Shock

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN3810151 Issued in OH

Practice address

125 E Broad St Ste 302
Elyria, OH 44035-6447

Phone

(440) 323-0258

NPI assigned

Jul 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: addie.shockcnp.p11@direct.loraincountyhealth.nextgenshare.com

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.

• Lorain County Health & Dentistry

  • Clinic/Center
  • Lorain, OH
  • NPI 1215194527
  Medicare reassignment NPD
• Lorain County Health & Dentistry

  • Community/Retail Pharmacy
  • Lorain, OH
  • NPI 1871304550
  NPD

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1215380423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9807 NICOLE LN",
            "city": "OLMSTED TWP",
            "state": "OH",
            "postal_code": "441384252",
            "telephone_number": "419-685-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST STE 302",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356447",
            "telephone_number": "440-323-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK",
        "first_name": "ADDIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN3810151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Joseph Sherlock, MD
• Heather Sherrill
• Ronald Michael Sherrod, D.C.
• Mehdi H Shishehbor, DO
• Shelley Shivak
• Jennifer Shockley, FNP-C
• Bryona Short
• SHS Lorain LLC
• Mary Kay Shuba, DDS
• John C Shultz, PHD

• Pediatric Nurse Practitioner in Elyria, OH
• Providers in Elyria, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.