Shannon Root

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1430014.SUPV Issued in OH

Practice address

171 Deeds Park Dr
Dayton, OH 45404-6500

Phone

(937) 641-4000

Fax

(937) 641-4500

NPI assigned

Sep 14, 2009

Last updated

Oct 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dayton Children's Hospital

  • Child & Adolescent Psychiatry Physician
  • Dayton, OH
  • NPI 1952480030

  Clinical

  Medicare reassignment NPD
• Dayton Children's Hospital

  • Social Worker
  • Dayton, OH
  • NPI 1548045503
  NPD

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1881927473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 DEEDS PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454046500",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Valley St.",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454042066",
            "country_code": "US",
            "telephone_number": "937-641-3060",
            "fax_number": "937-641-3285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 W Tech Blvd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453424865",
            "country_code": "US",
            "telephone_number": "937-641-4040",
            "fax_number": "937-641-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOT",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1430014.SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129698",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ronyak, OT
• Brittany Roof
• Kaitlyn Roof
• Nyla Roop
• Root 2 Crown LLC
• Rooted Foundations LLC
• Rooted Mother & Infant Care, LLC
• Brianna Maria Rooths
• Wysh Aalyiah Roper-Smith
• Katrice Marie Roper, PMHNP

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.