Kelly Ann Shank, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN261639 Issued in OH

Practice address

3350 Briarfield Blvd Ste 300
Maumee, OH 43537-9502

Phone

(419) 452-2140

Fax

(419) 873-6327

NPI assigned

Dec 16, 2005

Sex

Female

Sole proprietor

No

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Careline Poh100 LLCGroup PAC ID 7012395965, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Med1Care, LLC Home health agency, Findlay, OH, CCN 368362
• Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
• University of Toledo Medical Center Hospital, Toledo, OH, CCN 360048
• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Careline Poh100 LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Maumee, OH
  • NPI 1306414826
  Medicare reassignment Care Compare group NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  OH

  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  OH

  Medicare reassignment NPD
• Wound Med LLC

  • Nursing Care Agency
  • Shaker Heights, OH
  • NPI 1790521060
  Medicare reassignment
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Med1Care, LLC

  • Home Health Agency
  • Findlay, OH
  • NPI 1306057153
  Care Compare affiliation
• Medical University of Ohio at Toledo

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1811971302
  Care Compare affiliation
• Mercy Health - St Vincent Medical Center LLC

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• Ohioans Home Healthcare, Inc

  • Home Health Agency
  • Perrysburg, OH
  • NPI 1093836546
  Care Compare affiliation

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1922084425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 BRIARFIELD BLVD STE 300",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379502",
            "telephone_number": "419-452-2140",
            "fax_number": "419-873-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN261639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207347",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyra Kapri Settles, LPN
• Munir Shah, MD
• Raju S Shah, M.D.
• Yousef Fehr Shaheen
• Shamrock Respiratory Services, LLC
• Amy L Sharp
• Brittany L Sheaves, RN
• Brenda Sheely
• Jennifer Sherwin
• Shelby Ann Shidler

• Adult Health Nurse Practitioner in Maumee, OH
• Providers in Maumee, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.