Individual provider Active NPI

Chanelle Katarena Shamoun, MD

  • Hospitalist Physician
  • Barberton, OH
National Provider Identifier
1568923654
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.142822 Issued in OH
Practice address
155 5TH St NE
Barberton, OH 44203-3332
Phone
(330) 615-3205
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35.142822 OH Primary

Addresses

Primary practice location

155 5TH St NE
Barberton, OH 44203-3332

Mailing address

155 5TH St NE
Barberton, OH 44203-3332
Phone (330) 615-3205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220725001042 OH Practitioner - Hospitalist 1355762105 Reassigns benefits to 1 organization
I20240202000465 CA Practitioner - Hospitalist 1355762105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.142822OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Hospitalist Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2024 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2024 Accepting new patients
Columbus Inpatient Care Inc. CurrentSince Aug 1, 2022 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

5300 N Meadows Dr
Ste 7023
Grove City, OH 43123
Phone (614) 663-4242

5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242

Interoperability endpoints

  • Direct secure messaging: cshamoun2004021@direct.trinity-health.org
  • Direct secure messaging: cshamoun671181@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1568923654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 5TH ST NE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033332",
            "telephone_number": "330-615-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 5TH ST NE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033332",
            "telephone_number": "330-615-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMOUN",
        "first_name": "CHANELLE",
        "middle_name": "KATARENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.142822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barberton, OH

Sources for this page

Verify at the official NPI Registry.