Individual provider Active NPI

Shannon C Kiser, NP

  • Nurse Practitioner
  • Athens, OH
National Provider Identifier
1730414962
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10947-NP Issued in OH
Practice address
65 Hospital Dr
Cornwell Center
Athens, OH 45701-2302
Phone
(740) 566-4890
Fax
(740) 566-4891
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10947-NP OH Primary

Addresses

Primary practice location

65 Hospital Dr
Cornwell Center
Athens, OH 45701-2302

Mailing address

65 Hospital Dr
Cornwell Center
Athens, OH 45701-2302
Phone (740) 566-4890

Other identifiers 1

IdentifierTypeStateIssuer
3014017MedicaidOH

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
I20091106000389 OH Practitioner - Nurse Practitioner 9335287663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
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)

3705 Olentangy River Rd
Suite 100
Columbus, OH 43214-3467
Phone (614) 262-6772

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10947-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Current Accepting new patients
Ohiohealth Corporation CurrentSince Oct 29, 2015 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 29, 2015 Accepting new patients

Locations

65 Hospital Dr
Athens, OH 45701
Phone (740) 566-4890

75 Hospital Dr
Ste 310
Athens, OH 45701
Phone (740) 594-6100

3705 Olentangy River Rd
Ste 100
Columbus, OH 43214

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

3705 Olentangy River Rd
Columbus, OH 43214
Phone (614) 533-6620

Dept L3652
Columbus, OH 43260

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Organizations & group practices 3

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 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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1730414962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HOSPITAL DR",
            "address_2": "CORNWELL CENTER",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012302",
            "telephone_number": "740-566-4890",
            "fax_number": "740-566-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HOSPITAL DR",
            "address_2": "CORNWELL CENTER",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012302",
            "telephone_number": "740-566-4890",
            "fax_number": "740-566-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "SHANNON",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "10947-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014017",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.