SHERRI SHIVELY NP-C NPI 1275880122

NPI Information

NPI: 1275880122
Provider Name: SHERRI SHIVELY, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: NORTHERN OHIO MEDICAL SPECIALISTS, LLC

PECOS Registration: Yes

Address:
112 INDEPENDENCE WAY STE 110
CLYDE, OH
ZIP 43410
Phone: (419) 483-9000
Get Directions

Sherri Shively, NP-C is a family nurse practitioner in Clyde, OH with 12 years of experience. Sherri Shively, NP-C NPI is 1275880122. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TOLEDO MEDICAL COLLEGE
Graduation Year:2012

The provider's business location address is:

112 INDEPENDENCE WAY STE 110
CLYDE, OH
ZIP 43410-812
Phone: (419) 483-9000
Fax: (419) 483-9003

The NPI 1275880122 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 enumeration date for this NPI number is 8/9/2012 and was last updated on 9/21/2018.

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
1	363LF0000X	Nurse Practitioner	Family	COA.13509-NP	OHIO	Yes

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
1	0072039	MEDICAID	OHIO
2	P01221204	OTHER	OHIO	RR MEDICARE

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

NPI Synchronization or Removal

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