Individual provider Active NPI

Mary A. Shenigo, MD

  • Family Medicine Physician
  • Westerville, OH
National Provider Identifier
1447203377
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35065436 Issued in OH
Practice address
5773 Idana CT
Westerville, OH 43081-8932
Phone
(614) 746-8348
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35065436 OH Primary

Addresses

Primary practice location

5773 Idana CT
Westerville, OH 43081-8932

Mailing address

5773 Idana CT
Westerville, OH 43081-8932
Phone (614) 746-8348

Other identifiers 1

IdentifierTypeStateIssuer
2053423MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190327001258 OH Order and Referring Only - Family PracticePractitioner - Family Practice 2466435466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35065436OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dublin Urgent Care Inc Past Accepting new patients
Muskingum Emergency Physicia Past Accepting new patients
Genesis Urgent Care Physicians, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1447203377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5773 IDANA CT",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818932",
            "telephone_number": "614-746-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5773 IDANA CT",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818932",
            "telephone_number": "614-746-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENIGO",
        "first_name": "MARY",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35065436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2053423",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.