Individual provider Active NPI

Martha Ann Sheldrick, CNP

  • Family Nurse Practitioner
  • Centerville, OH
National Provider Identifier
1447503933
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA. 13944-NP Issued in OH
Practice address
212 Walnut Grove Dr
Centerville, OH 45458
Phone
(937) 238-9557
NPI assigned
Oct 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.13944-NP OH
Family Nurse Practitioner 363LF0000X COA. 13944-NP OH Primary

Addresses

Primary practice location

212 Walnut Grove Dr
Centerville, OH 45458

Mailing address

212 Walnut Grove Dr
Centerville, OH 45458-4156
Phone (937) 238-9557

Other practice location 1

909 E 2nd St
Franklin, OH 45005-1700
Phone (937) 746-8357

Other identifiers 1

IdentifierTypeStateIssuer
0080279MedicaidOH

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)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.13944-NPOHMDNurse Practitioner
COA. 13944-NPOHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1447503933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 WALNUT GROVE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584156",
            "telephone_number": "937-238-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 WALNUT GROVE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45458",
            "telephone_number": "937-238-9557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051700",
            "country_code": "US",
            "telephone_number": "937-746-8357",
            "fax_number": "937-746-1992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELDRICK",
        "first_name": "MARTHA",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-21",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.13944-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 13944-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080279",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.