Brooklyn Paige Shank, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0036394 Issued in OH

Practice address

1720 Ohiohealth Way FL 2
Ashland, OH 44805-9253

Phone

(567) 309-4000

NPI assigned

May 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brooklyn Paige Gottfried Former name

Electronic endpoints 1

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118
• University Hospitals Samaritan Medical Center Hospital, Ashland, OH, CCN 360002

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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.

• Ohiohealth Corporation

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment Care Compare group NPD
• Ohiohealth Corporation

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD

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

• Medcentral Health System

  • General Acute Care Hospital
  • Mansfield, OH
  • NPI 1790837235
  Care Compare affiliation
• Medcentral Health System

  • Clinical Medical Laboratory
  • Mansfield, OH
  • NPI 1962888016

  Hospital

  Care Compare affiliation
• Samaritan Regional Health System

  • General Acute Care Hospital
  • Ashland, OH
  • NPI 1902882939
  Care Compare affiliation

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1508614892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 OHIOHEALTH WAY FL 2",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059253",
            "telephone_number": "567-309-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "BROOKLYN",
        "middle_name": "PAIGE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0036394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bshank357014@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "1720 Ohiohealth Way Fl 2",
            "city": "Ashland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448059253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOKLYN",
            "last_name": "GOTTFRIED",
            "middle_name": "PAIGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Segura, LPC
• Kathy Lynn Seitz, RN, MSN, CNP
• Serenity Trauma Healing Center
• Pamela A Serpa, RNC
• William Benjamin Shaffer, CT
• Shannan C Ross MD Inc
• Diana Sharp
• Hannah Nicole Shaw, LSW
• Bethany Sherrieb, LSW
• Young Shin, MD

• Family Nurse Practitioner in Ashland, OH
• Providers in Ashland, 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 26, 2024; 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.