Active NPI
Brooke Shivener
- Licensed Practical Nurse
- Batavia, OH
National Provider Identifier
1376185082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 117706
- Practice address
- 4560 State Route 222
Batavia, OH 45103-9778 - Phone
- (513) 732-1601
- NPI assigned
- Oct 14, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 117706 | OH | Primary |
Addresses
Primary practice location
4560 State Route 222
Batavia, OH 45103-9778
Mailing address
105 Spring St Apt 3
Bethel, OH 45106-1420
Phone (513) 391-0124
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117706 | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridge HVP LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Abuse Rehabilitation Facility
- Batavia, OH
- NPI 1558616375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1376185082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SPRING ST APT 3",
"city": "BETHEL",
"state": "OH",
"postal_code": "451061420",
"telephone_number": "513-391-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 STATE ROUTE 222",
"city": "BATAVIA",
"state": "OH",
"postal_code": "451039778",
"telephone_number": "513-732-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVENER",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-14",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "117706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.