Active NPI
Mary Jane Shooner
- Marriage & Family Therapist
- Cincinnati, OH
National Provider Identifier
1962033779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- M.1900099
- Practice address
- 2211 Fulton Ave
Cincinnati, OH 45206-2504 - Phone
- (513) 961-4663
- NPI assigned
- Jan 30, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | M.1900099 | OH | Primary |
Addresses
Primary practice location
2211 Fulton Ave
Cincinnati, OH 45206-2504
Mailing address
5506 Timber CT
Milford, OH 45150-1789
Phone (513) 284-2719
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 |
|---|---|---|---|
| M.1900099 | OH | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1962033779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5506 TIMBER CT",
"city": "MILFORD",
"state": "OH",
"postal_code": "451501789",
"telephone_number": "513-284-2719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 FULTON AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452062504",
"telephone_number": "513-961-4663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOONER",
"first_name": "MARY",
"middle_name": "JANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-30",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OH",
"license": "M.1900099",
"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 Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.