Active NPI
Shannon Douglas
- Registered Nurse
- Akron, OH
National Provider Identifier
1790245975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN-397857
- Practice address
- 1230 Bye St
Akron, OH 44320-1902 - Phone
- (330) 245-7686
- NPI assigned
- Mar 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-397857 | OH | Primary |
Addresses
Primary practice location
1230 Bye St
Akron, OH 44320-1902
Mailing address
1230 Bye St
Akron, OH 44320-1902
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RQ094231 | Other | OH | DRIVER'S LICENSE |
| RN-397857 | Other | OH | OHIO BOARD OF NURSING |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN-397857 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1790245975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 BYE ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443201902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 BYE ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443201902",
"telephone_number": "330-245-7686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-22",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN-397857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "RQ094231",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BOARD OF NURSING",
"identifier": "RN-397857",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.