Individual provider Active NPI

Shelly R Persinger

  • Nurse's Aide
  • Mount Gilead, OH
National Provider Identifier
1235945379
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
400120000502 Issued in OH
Practice address
377 S Delaware St Apt 203
Mount Gilead, OH 43338-3005
Phone
(419) 834-3246
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X 400120000502 OH Primary

Addresses

Primary practice location

377 S Delaware St Apt 203
Mount Gilead, OH 43338-3005

Mailing address

377 S Delaware St Apt 203
Mount Gilead, OH 43338-3005
Phone (419) 834-3246

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

LicenseStateTypeSpecialty
400120000502OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1235945379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 S DELAWARE ST APT 203",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433383005",
            "telephone_number": "419-834-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 S DELAWARE ST APT 203",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433383005",
            "telephone_number": "419-834-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINGER",
        "first_name": "SHELLY",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "400120000502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Gilead, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.