Individual provider Active NPI

Katrina Marie Sheeler, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1588966741
Registry record updated Jan 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.137334-IV Issued in OH
Practice address
4712 Queens Ave
Dayton, OH 45406-3234
Phone
(937) 607-0757
NPI assigned
Nov 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 137334-IV OH
Licensed Practical Nurse 164W00000X PN.137334-IV OH Primary

Addresses

Primary practice location

4712 Queens Ave
Dayton, OH 45406-3234

Mailing address

4712 Queens Ave
Dayton, OH 45406-3234
Phone (937) 607-0757

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
137334-IVOHMDLicensed Practical Nurse
PN.137334-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1290297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1588966741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 QUEENS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063234",
            "telephone_number": "937-607-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 QUEENS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063234",
            "telephone_number": "937-607-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEELER",
        "first_name": "KATRINA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-21",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "137334-IV",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.137334-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2025; 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.