Shelby Ann Blymyer, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.165751 Issued in OH

Practice address

304 Madison St
Port Clinton, OH 43452

Phone

(419) 734-5535

NPI assigned

Sep 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sandusky County Office of Auditor

  • Public Health or Welfare Agency
  • Fremont, OH
  • NPI 1477605020
  NPD (past)
• Sandusky County Tasc

  • Addiction (Substance Use Disorder) Counselor
  • Fremont, OH
  • NPI 1245277755

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1922527019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MADISON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MADISON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "43452",
            "telephone_number": "419-734-5535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 N Clover St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "OH",
            "postal_code": "434202407",
            "country_code": "US",
            "telephone_number": "419-334-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLYMYER",
        "first_name": "SHELBY",
        "middle_name": "ANN",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.162260",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.165751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Behra, MOT
• Jamie Belcher, CHES, OCPS
• Christopher Bender
• Steven Benedict, M.D.
• Rejina K Blair
• Autumn Bodi
• David Andrew Bodie, M.D.
• Brittani Bonanno
• Matthew A Braniecki, D.O.
• Brideget N Urban DC LLC

• All providers in Port Clinton, OH
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.