Individual provider Active NPI

Casey J Shea, FNP-C

  • Family Nurse Practitioner
  • Marietta, OH
National Provider Identifier
1679066617
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024391 Issued in OH
Practice address
400 Matthew St Ste 303
Marietta, OH 45750-1656
Phone
(740) 373-7828
Fax
(740) 373-5898
NPI assigned
Jun 13, 2018
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024391 OH Primary
Family Nurse Practitioner 363LF0000X APRN78641-NP-C WV

Addresses

Primary practice location

400 Matthew St Ste 303
Marietta, OH 45750-1656

Mailing address

113 E 6TH St
Williamstown, WV 26187-1601
Phone (304) 481-1375

Other identifiers 1

IdentifierTypeStateIssuer
0336236MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address casey.shea@mmhs.medicity.net

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
I20190710000307 OH Practitioner - Nurse Practitioner 4587999834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

400 Matthew St
Marietta, OH 45750-1656

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN78641-NP-CWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Marietta Memorial Hospital CurrentSince Aug 12, 2019 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Marietta Memorial Hospital CurrentSince Aug 12, 2019 Accepting new patients

Locations

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

400 Matthew St
Ste 303
Marietta, OH 45750
Phone (740) 373-7828

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

416 Colegate Dr
#3
Marietta, OH 45750
Phone (740) 236-9047

701 Hildreth Ln
Marietta, OH 45750
Phone (740) 371-7194

Organizations & group practices 4

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 3

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1679066617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E 6TH ST",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871601",
            "telephone_number": "304-481-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST STE 303",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501656",
            "telephone_number": "740-373-7828",
            "fax_number": "740-373-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "CASEY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024391",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN78641-NP-C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0336236",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "casey.shea@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "400 Matthew St Ste 303",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.