Active NPI
Benjamin P Shores
- Social Worker
- Akron, OH
National Provider Identifier
1932459146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I1201219
- Practice address
- 640 W Market St
Akron, OH 44303-1413 - Phone
- (330) 762-5425
- Fax
- (330) 762-4019
- NPI assigned
- Sep 14, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | I1201219 | OH | Primary |
Addresses
Primary practice location
640 W Market St
Akron, OH 44303-1413
Mailing address
640 W Market St
Akron, OH 44303-1413
Phone (330) 762-5425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I1201219 | Other | OH | LICENSED INDEPENDENT SOCIAL WORKER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I1201219 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347580800000",
"number": "1932459146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 W MARKET ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443031413",
"telephone_number": "330-762-5425",
"fax_number": "330-762-4019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 W MARKET ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443031413",
"telephone_number": "330-762-5425",
"fax_number": "330-762-4019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORES",
"first_name": "BENJAMIN",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-14",
"last_updated": "2012-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I1201219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED INDEPENDENT SOCIAL WORKER",
"identifier": "I1201219",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.