Individual provider Active NPI

Shannon Cynthia Reardon, DO

  • Family Medicine Physician
  • Boardman, OH
National Provider Identifier
1962340299
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58.035565 Issued in OH
Practice address
8423 Market St Ste 101
Boardman, OH 44512-6778
Phone
(330) 729-8700
Fax
(330) 729-8701
NPI assigned
Mar 25, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58.035565 OH Primary

Addresses

Primary practice location

8423 Market St Ste 101
Boardman, OH 44512-6778

Mailing address

8423 Market St Ste 101
Boardman, OH 44512-6778
Phone (330) 729-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC Past Accepting new patients
Mercy Health Physicians Youngstown, LLC Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1962340299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "SHANNON",
        "middle_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.035565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.