Individual provider Active NPI

Shelly Mountjoy, RN, MSN, LSN

  • School Registered Nurse
  • Wooster, OH
National Provider Identifier
1275956963
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN194409 Issued in OH
Practice address
2695 Graustark Path
Wooster, OH 44691-1607
Phone
(330) 345-6475
Fax
(330) 345-8237
NPI assigned
Jan 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN194409 OH Primary

Addresses

Primary practice location

2695 Graustark Path
Wooster, OH 44691-1607

Mailing address

2695 Graustark Path
Wooster, OH 44691-1607
Phone (330) 345-6475

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
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN194409OHMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1275956963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 GRAUSTARK PATH",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911607",
            "telephone_number": "330-345-6475",
            "fax_number": "330-345-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 GRAUSTARK PATH",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911607",
            "telephone_number": "330-345-6475",
            "fax_number": "330-345-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTJOY",
        "first_name": "SHELLY",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, LSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OH",
            "license": "RN194409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.