NPIMap

Individual provider Active NPI

Shannon R Schlagbaum, MSN, CNP

  • Nurse Practitioner
  • Lima, OH
National Provider Identifier
1295174639
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.14615-NP Issued in OH
Practice address
801 Medical Dr
Suite a
Lima, OH 45804-4031
Phone
(419) 222-6622
Fax
(419) 224-0015
NPI assigned
Jun 19, 2013
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.14615-NP OH Primary
Family Nurse Practitioner 363LF0000X COA.14615-NP OH

Addresses

Primary practice location

801 Medical Dr
Suite a
Lima, OH 45804-4031

Mailing address

801 Medical Dr
Suite a
Lima, OH 45804-4031
Phone (419) 222-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000513 OH Practitioner - Nurse Practitioner 1456591478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1275 Greenville Rd
Saint Marys, OH 45885-9352
Phone (419) 394-4636

801 Medical Dr
Lima, OH 45804-4030
Phone (419) 222-6622

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.77 of 100Reported as group
Quality
62.75
Promoting interoperability
92
Improvement activities
40
Cost
73.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.14615-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Institute of Ohio, Inc CurrentSince Jun 18, 2013 Accepting new patients
Orthopaedic Institute of Ohio, Inc. CurrentSince Jun 18, 2013 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

801 Medical Dr
Lima, OH 45804
Phone (419) 227-0205

801 Medical Dr
Ste A
Lima, OH 45804
Phone 41922266223301

1275 E Greenville Rd
Saint Marys, OH 45885
Phone (419) 300-9790

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Interoperability endpoints

  • Direct secure messaging: shannonschlagbaum@glhs.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1295174639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044031",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044031",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAGBAUM",
        "first_name": "SHANNON",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MSN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.14615-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.14615-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.