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JACQUELINE S SHRIVER CRNP NPI 1083606610


NPI Information

NPI: 1083606610
Provider Name: JACQUELINE S SHRIVER, CRNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

Organization: JTDM FAMILY PRACTICE LLC

PECOS Registration: Yes

Address:
1140 S KNOXVILLE AVE STE B
SAINT MARYS, OH
ZIP 45885
Phone: (419) 394-7314
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Jacqueline S Shriver, CRNP is a women's health nurse practitioner in Saint Marys, OH with 28 years of experience. Jacqueline S Shriver, CRNP NPI is 1083606610. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1140 S KNOXVILLE AVE STE B
SAINT MARYS, OH
ZIP 45885-609
Phone: (419) 394-7314
Fax: (419) 394-7313

The NPI 1083606610 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)
  • Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous (HCPCS:G0328)

The enumeration date for this NPI number is 8/19/2005 and was last updated on 4/19/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LW0102XNurse PractitionerWomen's HealthNP2122OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10742307MEDICAIDOHIO
2H561340OTHEROHIOMEDICARE PTAN
31184652539OTHEROHIOGROUP NPI
40105065OTHEROHIOMEDICAID GROUP
59934723OTHEROHIOGROUP MEDICARE
634-1689161OTHEROHIOGROUP TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.