Individual provider Active NPI

Shelly Lynn Mizelle, RN

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1679890784
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.433122 Issued in OH
Practice address
1301 N High St
Columbus, OH 43201-2460
Phone
(614) 299-6600
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN.433122 OH Primary

Addresses

Primary practice location

1301 N High St
Columbus, OH 43201-2460

Mailing address

2199 Baldwin PL Apt J
Reynoldsburg, OH 43068-3659
Phone (614) 625-7350

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
139356OHMDLicensed Practical Nurse
PN139356OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1679890784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2199 BALDWIN PL APT J",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683659",
            "telephone_number": "614-625-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELLE",
        "first_name": "SHELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.433122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.