Active NPI
Shelby Lorraine Sheets
- Home Health Registered Nurse
- Montgomery, OH
National Provider Identifier
1629639240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 463648
- Practice address
- 10725 Old Pond Dr
Montgomery, OH 45249-3532 - Phone
- (513) 520-9639
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 463648 | OH | Primary |
Addresses
Primary practice location
10725 Old Pond Dr
Montgomery, OH 45249-3532
Mailing address
1211 Broadway St # 2
Cincinnati, OH 45202-7342
Phone (513) 262-7165
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
| License | State | Type | Specialty |
|---|---|---|---|
| 463648 | OH | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1629639240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 BROADWAY ST # 2",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452027342",
"telephone_number": "513-262-7165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10725 OLD POND DR",
"city": "MONTGOMERY",
"state": "OH",
"postal_code": "452493532",
"telephone_number": "513-520-9639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEETS",
"first_name": "SHELBY",
"middle_name": "LORRAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "OH",
"license": "463648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montgomery, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.