Individual provider Active NPI

Shelley Rae Cresong

  • Nurse's Aide
  • Middletown, OH
National Provider Identifier
1245069418
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
602329520321 Issued in OH
Practice address
2516 Buckingham CT
Middletown, OH 45044-7189
Phone
(513) 571-9527
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 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 Aide 376K00000X 602329520321 OH Primary

Addresses

Primary practice location

2516 Buckingham CT
Middletown, OH 45044-7189

Mailing address

2516 Buckingham CT
Middletown, OH 45044-7189
Phone (513) 571-9527

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
602329520321OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1245069418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 BUCKINGHAM CT",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450447189",
            "telephone_number": "513-571-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 BUCKINGHAM CT",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450447189",
            "telephone_number": "513-571-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESONG",
        "first_name": "SHELLEY",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "602329520321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.