Jeanetta Jean Shriver, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA12752-NP Issued in OH

Practice address

294 E Main St
Jackson, OH 45640-1745

Phone

(740) 577-3132

Fax

(740) 577-3156

NPI assigned

Oct 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jeanetta Jean Shriver FNP-BC Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Ross, CNP

  • Nurse Practitioner
  • Wheelersburg, OH
  • NPI 1932584869
  Medicare reassignment

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.

• Shriver Family Practice LTD.

  • Family Nurse Practitioner
  • Jackson, OH
  • NPI 1043557390
  NPD (past) Authorized official

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1497030811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 E MAIN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401745",
            "telephone_number": "740-577-3132",
            "fax_number": "740-577-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 E MAIN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401745",
            "telephone_number": "740-577-3132",
            "fax_number": "740-577-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "JEANETTA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA12752-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTA",
            "last_name": "SHRIVER FNP-BC",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "MSN  FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Abbie Sheets
• Virginia Lee Shields, LPN
• Ashley N Shiveley
• Heather Shook, FNP-BC
• Shriver Family Practice LTD.
• Dwight Sloan Shumate, D.D.S.
• Lorie Lynn Siders, RDN
• Haley Simmonds
• Maximilian Simpson, HIS
• Samantha J Simpson

• Family Nurse Practitioner in Jackson, OH
• Providers in Jackson, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.