Individual provider Active NPI

Kristi Shoewalter

  • Home Health Agency
  • Mount Vernon, OH
National Provider Identifier
1417875626
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
4204794 Issued in OH
Practice address
30 Woodlake TRL
Mount Vernon, OH 43050-9132
Phone
(740) 398-0636
NPI assigned
Jul 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 4204794 OH Primary

Addresses

Primary practice location

30 Woodlake TRL
Mount Vernon, OH 43050-9132

Mailing address

30 Woodlake TRL
Mount Vernon, OH 43050-9132
Phone (740) 398-0636

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

NPI Registry JSON

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

{
    "created_epoch": "1783382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1417875626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WOODLAKE TRL",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509132",
            "telephone_number": "740-398-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WOODLAKE TRL",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509132",
            "telephone_number": "740-398-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEWALTER",
        "first_name": "KRISTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-07",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "4204794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.