Individual provider Active NPI

Kelly Arlene Shaarda, CNP

  • Family Nurse Practitioner
  • Greenwich, OH
National Provider Identifier
1659601912
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0035069 Issued in OH
Practice address
65 W Main St
Greenwich, OH 44837-1030
Phone
(419) 752-1811
Fax
(419) 452-2145
NPI assigned
Jan 9, 2010
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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.0035069 OH Primary

Addresses

Primary practice location

65 W Main St
Greenwich, OH 44837-1030

Mailing address

65 W Main St
Greenwich, OH 44837-1030

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
I20240124001674 OH Practitioner - Nurse Practitioner 3476906694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

65 W Main St
Greenwich, OH 44837-1030
Phone (419) 752-1811

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-North LLC CurrentSince Dec 19, 2023 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Dec 19, 2023 Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

65 W Main St
Greenwich, OH 44837
Phone (419) 752-1811

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

Interoperability endpoints

  • Direct secure messaging: kshaarda27401@direct.bsmhealth.org

Organizations & group practices 3

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 1

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": "1262995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1659601912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W MAIN ST",
            "city": "GREENWICH",
            "state": "OH",
            "postal_code": "448371030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W MAIN ST",
            "city": "GREENWICH",
            "state": "OH",
            "postal_code": "448371030",
            "telephone_number": "419-752-1811",
            "fax_number": "419-452-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAARDA",
        "first_name": "KELLY",
        "middle_name": "ARLENE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-09",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0035069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, OH

Sources for this page

Verify at the official NPI Registry.