Shannon Nicole Jap, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

001598 Issued in GA

Practice address

571 High St Ste 11
Worthington, OH 43085-4132

Phone

(614) 226-5484

Fax

(937) 606-3077

NPI assigned

Jan 25, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Shannon Jap MD LLC

  • Multi-Specialty Clinic/Center
  • Worthington, OH
  • NPI 1962986372
  NPD Authorized official

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1508043118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 HIGH ST STE 11",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854132",
            "telephone_number": "614-226-5484",
            "fax_number": "937-606-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 HIGH ST STE 11",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854132",
            "telephone_number": "614-226-5484",
            "fax_number": "937-606-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAP",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "001598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caleb Jean
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• Psychiatry Physician in Worthington, OH
• Providers in Worthington, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.