Individual provider Active NPI

Shawn Thomas Maruschak, LPN

  • Licensed Practical Nurse
  • Clearfield, PA
National Provider Identifier
1669272258
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN313554 Issued in PA
Practice address
214 Airport Rd
Clearfield, PA 16830-6126
Phone
(814) 768-7575
Fax
(814) 768-9754
NPI assigned
Mar 14, 2025
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN313554 PA Primary

Addresses

Primary practice location

214 Airport Rd
Clearfield, PA 16830-6126

Mailing address

214 Airport Rd
Clearfield, PA 16830-6126
Phone (814) 768-7575

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

LicenseStateTypeSpecialty
PN313554PAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery House Cu, LLC CurrentSince Mar 20, 2025 Accepting new patients

Locations

214 Airport Rd
Clearfield, PA 16830
Phone (814) 205-9900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1669272258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 AIRPORT RD",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168306126",
            "telephone_number": "814-768-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 AIRPORT RD",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168306126",
            "telephone_number": "814-768-7575",
            "fax_number": "814-768-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUSCHAK",
        "first_name": "SHAWN",
        "middle_name": "THOMAS",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN313554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.