SHELBY PRIMARY CARE LLC NPI 1174660112

NPI Information

  • NPI: 1174660112
  • Provider Name: SHELBY PRIMARY CARE LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 36D0992662
  • Address: 24 E WHITNEY AVE
    SHELBY, OH
    ZIP 44875
  • Phone: (419) 347-2828

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NPI Details

SHELBY PRIMARY CARE LLC is a family medicine in Shelby, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SHELBY PRIMARY CARE LLC NPI is 1174660112. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24 E WHITNEY AVE
SHELBY, OH
ZIP 44875-246
Phone: (419) 347-2828
Fax: (419) 347-2246

The provider's authorized official is Marion C Demers .
The authorized official title is Owner and has the following contact phone number (419) 347-2828.

The CLIA number assigned to this NPI record is 36D0992662 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/31/2007 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12350030MEDICAIDOHIO

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: 11/21/2025

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