Individual provider Active NPI

Anthony Alan Shumway, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middleburg Heights, OH
National Provider Identifier
1982836425
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP10886 Issued in OH
Practice address
7530 Lucerne Dr Ste 110
Middleburg Heights, OH 44130-6557
Phone
(440) 234-8746
NPI assigned
Aug 18, 2009
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP10886 OH Primary

Addresses

Primary practice location

7530 Lucerne Dr Ste 110
Middleburg Heights, OH 44130-6557

Mailing address

7530 Lucerne Dr Ste 110
Cleveland, OH 44130-6557
Phone (440) 234-8746

Other identifiers 1

IdentifierTypeStateIssuer
0065524MedicaidOH

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000422 OH Practitioner - Nurse Practitioner 8628103199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florence Kimbo MD LLCGroup PAC ID 4183850423, 13 clinicians

Practice addresses (Care Compare)

7530 Lucerne Dr
Suite 110
Middleburg Heights, OH 44130-6557
Phone (440) 234-8746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP10886OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Kimbo M.D., LLC CurrentSince Sep 24, 2015 Accepting new patients
Portage Path Behavioral Health Past Accepting new patients
Portage Path Community Mental Health Center Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

18660 Bagley Rd
Bldg 1
Middleburg Heights, OH 44130
Phone (440) 234-8746

18660 Bagley Rd
Ste 404
Middleburg Heights, OH 44130
Phone (440) 234-8746

7530 Lucerne Dr
Ste 110
Middleburg Heights, OH 44130
Phone 4402348746 ext. 48746

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1982836425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 LUCERNE DR STE 110",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441306557",
            "telephone_number": "440-234-8746",
            "fax_number": "440-234-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 LUCERNE DR STE 110",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306557",
            "telephone_number": "440-234-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMWAY",
        "first_name": "ANTHONY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-18",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "NP10886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065524",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.