Theodore Paul Shannon, PHD, MS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C 0700153 Issued in OH

Practice address

1035 Proprietors Rd
Worthington, OH 43085-3230

Phone

(614) 785-1115

Fax

(614) 785-0095

NPI assigned

Aug 23, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Counseling Inc.Group PAC ID 1052203445, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Central Ohio Counseling Inc.

  • Clinical Social Worker
  • Worthington, OH
  • NPI 1922031988
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1992085831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PROPRIETORS RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853230",
            "telephone_number": "614-785-1115",
            "fax_number": "614-785-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PROPRIETORS RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853230",
            "telephone_number": "614-785-1115",
            "fax_number": "614-785-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "THEODORE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C 0700153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayishatu Shaibu
• Shalem Institute
• Shannan Chiropractic Care LLC
• Kevin J Shannan, D.C.
• Shannon Jap MD LLC
• Dylan Sharkey
• Carl E Sharp, DPM
• Danielle Sharp, PCC
• Jennifer Lynn Shawver
• Gordon N Shecket, MD

• Counselor in Worthington, OH
• Providers in Worthington, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.