Individual provider Active NPI

Shannan L Robenalt, CNP

  • Family Nurse Practitioner
  • Lima, OH
National Provider Identifier
1598303455
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.026239 Issued in OH
Practice address
803 W Market St Ste 200
Lima, OH 45805-2796
Phone
(419) 222-3737
Fax
(419) 229-3234
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.026239 OH Primary

Addresses

Primary practice location

803 W Market St Ste 200
Lima, OH 45805-2796

Mailing address

803 W Market St
Lima, OH 45805-2796

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200227000957 OH Practitioner - Nurse Practitioner 5294162426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

900 Havemann Rd
Suite B
Celina, OH 45822-1870
Phone (419) 586-0990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Aug 14, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Gi Physicians Inc PastSince Jun 1, 2021 Accepting new patients
Lima Memorial Professional Corporation PastSince Dec 1, 2019 Accepting new patients

Locations

900 Havemann Rd
Ste B
Celina, OH 45822
Phone (419) 586-0990

803 W Market St
Ste 200
Lima, OH 45805
Phone (419) 222-3737

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

Interoperability endpoints

  • Direct secure messaging: srobenalt416358@direct.bsmhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1598303455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W MARKET ST STE 200",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052796",
            "telephone_number": "419-222-3737",
            "fax_number": "419-229-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBENALT",
        "first_name": "SHANNAN",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.