Individual provider Active NPI

Stephanie Lynn Shanks, CNP

  • Family Nurse Practitioner
  • Perrysburg, OH
National Provider Identifier
1396382594
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP026049 Issued in OH
Practice address
12623 Eckel Junction Rd Ste 2600
Perrysburg, OH 43551-1304
Phone
(567) 368-1700
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP026049 OH Primary

Addresses

Primary practice location

12623 Eckel Junction Rd Ste 2600
Perrysburg, OH 43551-1304

Mailing address

900 W South Boundary St BLDG 9a
Perrysburg, OH 43551-5245
Phone (567) 368-1700

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
I20200205001871 OH Practitioner - Nurse Practitioner 8628404944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2200 Jefferson Ave
Toledo, OH 43604-7101
Phone (419) 225-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP026049OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC CurrentSince Jan 2, 2020 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jan 2, 2020 Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

900 W South Boundary St
Bldg 9A
Perrysburg, OH 43551
Phone (419) 872-3010

12623 Eckel Junction Rd
Ste 2600
Perrysburg, OH 43551
Phone (567) 368-1490

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2200 Jefferson Ave
Toledo, OH 43604
Phone (419) 241-1400

Interoperability endpoints

  • Direct secure messaging: sshanks97571@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1396382594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W SOUTH BOUNDARY ST BLDG 9A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515245",
            "telephone_number": "567-368-1700",
            "fax_number": "567-368-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12623 ECKEL JUNCTION RD STE 2600",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511304",
            "telephone_number": "567-368-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP026049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.