Individual provider Active NPI

Shannon Lee Storey Petros, NP-C

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1700339421
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.023574 Issued in OH
Practice address
800 McConnell Dr
Columbus, OH 43214-3463
Phone
(614) 566-5019
NPI assigned
Jul 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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 0024173784 VA
Family Nurse Practitioner 363LF0000X APRN.CNP.023574 OH Primary

Addresses

Primary practice location

800 McConnell Dr
Columbus, OH 43214-3463

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

901 Correction Way
Jarratt, VA 23870-9998
Phone (434) 535-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstorey378137@direct.ohiohealth.com OhioHealth Physician Group

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
I20181005001689 OH Practitioner - Nurse Practitioner 7810260809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

800 McConnell Rd
Columbus, OH 43214-3463
Phone (614) 533-6001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023574OHMDFamily Nurse Practitioner
0024173784VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2020 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

800 McConnell Dr
Columbus, OH 43214
Phone (614) 533-6297

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1700339421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MCCONNELL DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143463",
            "telephone_number": "614-566-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Correction Way",
            "address_purpose": "LOCATION",
            "city": "Jarratt",
            "state": "VA",
            "postal_code": "238709998",
            "country_code": "US",
            "telephone_number": "434-535-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOREY PETROS",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173784",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstorey378137@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "800 McConnell Dr",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.