Individual provider Active NPI

Shawn Patrick Millison, APRN.CNP

  • Family Nurse Practitioner
  • Poland, OH
National Provider Identifier
1477122174
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029096 Issued in OH
Practice address
715 E Western Reserve Rd
Poland, OH 44514-3358
Phone
(330) 726-3204
Fax
(330) 729-9316
NPI assigned
Jun 18, 2021
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0029096 OH Primary

Addresses

Primary practice location

715 E Western Reserve Rd
Poland, OH 44514-3358

Mailing address

4681 Mahoning Ave NW
Warren, OH 44483-1418

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726003578 OH Practitioner - Nurse Practitioner 0941603161 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7880 Lincole PL
Lisbon, OH 44432-8322
Phone (330) 424-5686

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029096OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Action Agency of Columbiana County Inc CurrentSince Sep 17, 2021 Accepting new patients
Zachary F. Veres D.O., LLC CurrentSince Oct 1, 2021 Accepting new patients
Community Action Agency of Columbiana County Inc CurrentSince Sep 17, 2021 Accepting new patients
Champion Med Express Care LLC CurrentSince Oct 1, 2021 Accepting new patients
Verodana, Inc CurrentSince Jul 1, 2021 Accepting new patients
Community Action Agency of Columbiana County, Inc Past Accepting new patients
Community Action Agency of Columbiana County Inc Past Accepting new patients

Locations

16480 Saint Clair Ave
East Liverpool, OH 43920
Phone (330) 386-7777

16494 Saint Clair Ave
East Liverpool, OH 43920
Phone (330) 386-7870

7880 Lincole Pl
Lisbon, OH 44432
Phone (330) 424-5686

2376 Southeast Blvd
Salem, OH 44460
Phone (330) 337-7255

103 W Main St
Salineville, OH 43945
Phone (330) 679-2303

4681 Mahoning Ave NW
Warren, OH 44483
Phone (330) 847-7778

4687 Mahoning Ave NW
Warren, OH 44483
Phone (330) 847-1132

Interoperability endpoints

  • Direct secure messaging: shawn.millison.p1@direct.sandy.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1477122174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4681 MAHONING AVE NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-726-3204",
            "fax_number": "330-729-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLISON",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "credential": "APRN.CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-18",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.