Individual provider Active NPI

Mark Kevin Sheline, PRS

  • Peer Specialist
  • North Olmsted, OH
National Provider Identifier
1407715550
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
APS.000072 Issued in OH
Practice address
23948 Elm Rd
North Olmsted, OH 44070-3730
Phone
(216) 673-5768
NPI assigned
Jan 15, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X APS.000072 OH Primary

Addresses

Primary practice location

23948 Elm Rd
North Olmsted, OH 44070-3730

Mailing address

23948 Elm Rd
North Olmsted, OH 44070-3730
Phone (216) 673-5768

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

LicenseStateTypeSpecialty
APS.000072OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1768435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1407715550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23948 ELM RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703730",
            "telephone_number": "216-673-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23948 ELM RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703730",
            "telephone_number": "216-673-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELINE",
        "first_name": "MARK",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PRS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.000072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Olmsted, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.