Active NPI
Shannon Poltor
- Registered Nurse
- Youngstown, OH
National Provider Identifier
1831882497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.511918
- Practice address
- 920 Boardman Canfield Rd
Youngstown, OH 44512-4218 - Phone
- (330) 953-3300
- NPI assigned
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
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.511918 | OH | Primary |
Addresses
Primary practice location
920 Boardman Canfield Rd
Youngstown, OH 44512-4218
Mailing address
5760 Patriot Blvd Ste D
Austintown, OH 44515-1170
Phone (330) 953-0243
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.511918 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1831882497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5760 PATRIOT BLVD STE D",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445151170",
"telephone_number": "330-953-0243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 BOARDMAN CANFIELD RD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445124218",
"telephone_number": "330-953-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLTOR",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.511918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.