Individual provider Active NPI

Heather Shook, FNP-BC

  • Family Nurse Practitioner
  • Jackson, OH
National Provider Identifier
1306633342
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0039016 Issued in OH
Practice address
551 State Route 788
Jackson, OH 45640-8910
Phone
(740) 497-3945
NPI assigned
Apr 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APRN.CNP.0039016 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0039016 OH Primary

Addresses

Primary practice location

551 State Route 788
Jackson, OH 45640-8910

Mailing address

551 State Route 788
Jackson, OH 45640-8910
Phone (740) 497-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703000937 OH Practitioner - Nurse Practitioner 1052824893 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jul 25, 2025 Accepting new patients
CNP Operating Co LLC CurrentSince May 25, 2025 Accepting new patients

Locations

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1306633342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 STATE ROUTE 788",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456408910",
            "telephone_number": "740-497-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 STATE ROUTE 788",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456408910",
            "telephone_number": "740-497-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "HEATHER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "APRN.CNP.0039016",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0039016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

Verify at the official NPI Registry.