Individual provider Active NPI

Shirley Ohn, M.D.

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1831254499
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13862 Issued in AZ
Practice address
919 12TH PL Ste 6
Prescott, AZ 86305-1433
Phone
(928) 445-4166
Fax
(928) 776-9668
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13862 AZ Primary

Addresses

Primary practice location

919 12TH PL Ste 6
Prescott, AZ 86305-1433

Mailing address

919 12TH PL Ste 6
Prescott, AZ 86305-1433
Phone (928) 445-4166

Other identifiers 1

IdentifierTypeStateIssuer
228975MedicaidAZ

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13862AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1831254499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 6",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-445-4166",
            "fax_number": "928-776-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 6",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-445-4166",
            "fax_number": "928-776-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHN",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "13862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228975",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.