Individual provider Active NPI

Christopher Sean Shoemaker, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
National Provider Identifier
1497040810
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA175081 Issued in OH
Practice address
280 N Main St
Mansfield, OH 44902-7317
Phone
(419) 524-5013
Fax
(419) 524-5021
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA175081 OH Primary

Addresses

Primary practice location

280 N Main St
Mansfield, OH 44902-7317

Mailing address

921 N Main St
Mansfield, OH 44903-8113
Phone (419) 524-5013

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA175081OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America Ohio & Indiana CurrentSince Apr 11, 2021 Accepting new patients
Volunteers of America Ohio & Indiana Addiction (Substance Use Disorder) CurrentSince Apr 11, 2021 Accepting new patients

Locations

923 N Main St
Mansfield, OH 44903
Phone (419) 524-5013

921 N Main St
Mansfield, OH 44903
Phone (419) 524-5013

280 N Main St
Mansfield, OH 44902
Phone (419) 524-5013

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/voaohin/r4/

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1497040810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 N MAIN ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449038113",
            "telephone_number": "419-524-5013",
            "fax_number": "419-524-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N MAIN ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449027317",
            "telephone_number": "419-524-5013",
            "fax_number": "419-524-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "SEAN",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA175081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.