Active NPI
Marchelle D Shaw-Donald
- Adult Care Home Facility
- Cincinnati, OH
National Provider Identifier
1952135857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 03-78741
- Practice address
- 11865 Kittrun CT
Cincinnati, OH 45231-1183 - Phone
- (216) 269-2765
- NPI assigned
- Sep 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility (Mental Illness) | 3104A0625X | 03-78741 | OH | |
| Adult Care Home Facility | 311ZA0620X | 03-78741 | OH | Primary |
Addresses
Primary practice location
11865 Kittrun CT
Cincinnati, OH 45231-1183
Mailing address
11865 Kittrun CT
Cincinnati, OH 45231-1183
Phone (216) 269-2765
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 |
|---|---|---|---|
| 03-78741 | OH | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1952135857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11865 KITTRUN CT",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452311183",
"telephone_number": "216-269-2765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11865 KITTRUN CT",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452311183",
"telephone_number": "216-269-2765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW-DONALD",
"first_name": "MARCHELLE",
"middle_name": "D",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-02",
"last_updated": "2024-09-02",
"certification_date": "2024-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": "OH",
"license": "03-78741",
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "OH",
"license": "03-78741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.