Individual provider Active NPI

Latonya R Shoulders

  • Nurse Practitioner
  • Kent, OH
National Provider Identifier
1316406754
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.024294 Issued in OH
Practice address
5361 Mallard Cir
Kent, OH 44240-5626
Phone
(216) 536-2991
NPI assigned
Mar 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.024294 OH Primary

Addresses

Primary practice location

5361 Mallard Cir
Kent, OH 44240-5626

Mailing address

5361 Mallard Cir
Kent, OH 44240-5626
Phone (216) 536-2991

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
I20190726000401 OH Practitioner - Nurse Practitioner 4082940135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Akron General Medical CenterGroup PAC ID 8426961061, 117 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6047

Hospital & facility affiliations

  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024294OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Integrated Health, LLC Nurse Practitioner CurrentSince Aug 7, 2019 Accepting new patients
Akron General Medical Center CurrentSince Jan 11, 2021 Accepting new patients
Akron General Medical Center CurrentSince Jan 11, 2021 Accepting new patients

Locations

4125 Medina Rd
Ste 101
Akron, OH 44333

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

4127 Medina Rd
Ste 104
Akron, OH 44333
Phone (330) 344-6294

1940 Town Park Blvd
Green, OH 44685
Phone (330) 869-5010

914 Trailwood Dr
Youngstown, OH 44512
Phone (330) 758-6440

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1316406754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5361 MALLARD CIR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442405626",
            "telephone_number": "216-536-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5361 MALLARD CIR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442405626",
            "telephone_number": "216-536-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "LATONYA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.