Individual provider Active NPI

Shawna S Shafer, DO

  • Neonatal-Perinatal Medicine Physician
  • Toledo, OH
National Provider Identifier
1447418157
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
011708 Issued in OH
Practice address
2142 N Cove Blvd
3Rd Floor Toledo Children'S Hospital
Toledo, OH 43606-3895
Phone
(419) 291-4225
Fax
(419) 479-6193
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 011708 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
3Rd Floor Toledo Children'S Hospital
Toledo, OH 43606-3895

Mailing address

2142 North Cove Blvd, 3Rd Floor
PO Box 12498
Toledo, OH 43606-0098
Phone (419) 291-4225

Other identifiers 4

IdentifierTypeStateIssuer
4879554OtherAETNA
1447418157MedicaidMI
0129098MedicaidOH
10256OtherPARAMOUNT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Shawna.ShaferDO@promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140829001406 MD Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042438210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011708OHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital Pediatrics Past Accepting new patients
Toledo Childrens Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shawna.shaferdo@promedica.org

Organizations & group practices 2

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1447418157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 NORTH COVE BLVD, 3RD FLOOR",
            "address_2": "PO BOX 12498",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436060098",
            "telephone_number": "419-291-4225",
            "fax_number": "419-479-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "address_2": "3RD FLOOR TOLEDO CHILDREN'S HOSPITAL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-4225",
            "fax_number": "419-479-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "SHAWNA",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "011708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4879554",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447418157",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129098",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "10256",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shawna.ShaferDO@promedica.org",
            "affiliation": "N",
            "endpointDescription": "Secure Work Email",
            "address_1": "2142 N Cove Blvd",
            "address_2": "3rd Floor Toledo Children's Hospital",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436063895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.