Shazeeda Bakhsh, APRN-CNP
Individual provider Active NPI Family Nurse Practitioner · Sylvania, OH
NPI 1386284172 · NPPES record last updated Sep 29, 2024
Key facts
- NPI
- 1386284172
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 026118 (OH)
- Practice address
- 6075 Barkwood LN
Sylvania, OH 43560-2215 - Phone
- (567) 277-3122
- NPI assigned
- Jan 9, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210315000111 | OH | Practitioner - Nurse Practitioner | 6204242613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026118 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WLB Interventional, LLC | Past |
Accepting new patients | |
| West Toledo Urgent Care LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 026118 | OH | Yes |
Addresses
Primary practice location
6075 Barkwood LN
Sylvania, OH 43560-2215
Mailing address
1500 Holland Rd
Maumee, OH 43537-1619
Phone (419) 893-2775
Other providers in Sylvania, OH
- Robert G Axonovitz
- Hani A Badi
- April Louise Baker
- Marianna Serena Baker
- Rachel Baker
- Jeromy Lee Balduf
- Donna Lynne Baldwin-Mickey
- Katherine Louise Ball
- Margaret E. Ball
- Sara Ballou
All providers in Sylvania, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.