Individual provider Active NPI

Tracy E Shannon, PSYD

  • Rehabilitation Psychologist
  • Columbus, OH
National Provider Identifier
1972839660
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
License
P.7251 Issued in OH
Practice address
480 Medical Center Dr
Columbus, OH 43210-1229
Phone
(614) 293-3830
Fax
(614) 293-4870
NPI assigned
Oct 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X P.7251 OH Primary

Addresses

Primary practice location

480 Medical Center Dr
Columbus, OH 43210-1229

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-3830

Other practice location 1

543 Taylor Ave Ste 3002
Columbus, OH 43203-1278
Phone (614) 688-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150312001759 OH Practitioner - Clinical Psychologist 2860715885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Physical Medicine and Rehabilitation LLCGroup PAC ID 7012960644, 35 clinicians
Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

480 Medical Ctr Dr
Columbus, OH 43210-1229
Phone (614) 293-3830

543 Taylor Ave
Columbus, OH 43203-1278
Phone (614) 688-6470

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P.7251OHMDRehabilitation Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Physical Medicine and Rehabilitation, LLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

480 Medical Center Dr
Columbus, OH 43210
Phone (614) 293-3830

543 Taylor Ave
Ste 3002
Columbus, OH 43203
Phone (614) 688-6400

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

480 W 9th Ave
#2145
Columbus, OH 43210
Phone (614) 421-3830

480 Medical Center Dr
#2145
Columbus, OH 43210
Phone (614) 293-3830

543 Taylor Ave
Columbus, OH 43203
Phone (614) 685-3333

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1972839660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-3830",
            "fax_number": "614-293-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MEDICAL CENTER DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101229",
            "telephone_number": "614-293-3830",
            "fax_number": "614-293-4870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Taylor Ave Ste 3002",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432031278",
            "country_code": "US",
            "telephone_number": "614-688-6400",
            "fax_number": "614-688-6541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "TRACY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OH",
            "license": "P.7251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.