Individual provider Active NPI

Tavarus Chance Shurelds, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1366218554
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0035442 Issued in OH
Practice address
7197 Windswept Way
Columbus, OH 43235-5748
Phone
(614) 312-6708
NPI assigned
Nov 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0035442 OH Primary

Addresses

Primary practice location

7197 Windswept Way
Columbus, OH 43235-5748

Mailing address

465 Harmon Ave
Columbus, OH 43223
Phone (614) 358-4172

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
I20240920001551 OH Practitioner - Nurse Practitioner 3779024419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0035442OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince Jul 8, 2024 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince Jul 8, 2024 Accepting new patients
Recovery Innovations, Inc Past Accepting new patients

Locations

525 Metro Pl N
Ste 300
Dublin, OH 43017
Phone (614) 336-9600

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1366218554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 HARMON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43223",
            "telephone_number": "614-358-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7197 WINDSWEPT WAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432355748",
            "telephone_number": "614-312-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURELDS",
        "first_name": "TAVARUS",
        "middle_name": "CHANCE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-28",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0035442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.