Individual provider Active NPI

Patricia Elise Shaughnessy, WHNP

  • Women's Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1962697938
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
09622 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 584-4318
Fax
(513) 584-3020
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN228160 OH
Women's Health Nurse Practitioner 363LW0102X 28129783A IN
Women's Health Nurse Practitioner 363LW0102X 09622 OH Primary

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

2830 Victory Pkwy
Cincinnati, OH 45206-1785
Phone (513) 245-3335

Other identifiers 3

IdentifierTypeStateIssuer
RN228160OtherOHSTATE LICENSE NUMBER
200936880MedicaidIN
000000640123OtherINANTHEM PROVIDER NUMBER

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN228160OHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Past Accepting new patients
Hospice of Southwest Ohio, Inc. 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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1962697938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-245-3335",
            "fax_number": "513-475-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-4318",
            "fax_number": "513-584-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "PATRICIA",
        "middle_name": "ELISE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "RN228160",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "28129783A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "09622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "RN228160",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200936880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000640123",
            "state": "IN"
        }
    ],
    "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 Oct 5, 2010; 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.