Active NPI
Jonathan Shado, STNA.
- Nurse's Aide
- Westerville, OH
National Provider Identifier
1659776961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 401229350411
- Practice address
- 5866 Albany Trce
Westerville, OH 43081-8890 - Phone
- (614) 772-7012
- NPI assigned
- Oct 29, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 401229350411 | OH | Primary |
Addresses
Primary practice location
5866 Albany Trce
Westerville, OH 43081-8890
Mailing address
5866 Albany Trce
Westerville, OH 43081-8890
Phone (614) 772-7012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3151664 | Medicaid | OH |
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 |
|---|---|---|---|
| 401229350411 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414540800000",
"number": "1659776961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5866 ALBANY TRCE",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430818890",
"telephone_number": "614-772-7012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5866 ALBANY TRCE",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430818890",
"telephone_number": "614-772-7012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADO",
"first_name": "JONATHAN",
"credential": "STNA.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-29",
"last_updated": "2014-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "401229350411",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3151664",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.