Sally Mae Shull-Diener, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP08368 Issued in OH

Practice address

4640 W Alexis Rd
Toledo, OH 43623-1006

Phone

(419) 843-8150

Fax

(419) 479-2579

NPI assigned

May 11, 2006

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 identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1629028477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 W ALEXIS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436231006",
            "telephone_number": "419-843-8150",
            "fax_number": "419-479-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 W ALEXIS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436231006",
            "telephone_number": "419-843-8150",
            "fax_number": "419-479-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL-DIENER",
        "first_name": "SALLY",
        "middle_name": "MAE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP08368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000475788",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2614559",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00301721",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Shryock, CNP
• Mohammed Shuaib
• Huma Shujaat, D.O
• Devin E Shuler
• Sabrina Evette Shuler
• Sayler M Shull
• Shuller & Kravitz, Inc.
• Briana N Shumake, LSW
• Ideshia La'Veen Marie Shumaker
• Ricahrd P Shumate, DDS

• Nurse Practitioner in Toledo, OH
• Providers in Toledo, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.