MRS. JACQUELINE S SHRIVER (NPI# 1083606610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083606610 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE S SHRIVER |
| Credential | CRNP |
| Practice Address |
1067 Hager St Grand Lake Ob/gyn Saint Marys OH 45885-2422 |
| Mailing Address |
200 Saint Clair Ave Saint Marys OH 45885-2400 |
| Practice Telephone | 4193947314 |
| Practice Fax Number | 4193947313 |
| Mailing Telephone | 4193001129 |
| Mailing Fax Number | 4193949575 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2020-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
NP2122 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | GROUP MEDICARE | 9934723 | 01 |
| OH | 0742307 | 05 | |
| OH | GROUP NPI | 1184652539 | 01 |
| OH | GROUP TAX ID | 34-1689161 | 01 |
| OH | MEDICARE PTAN | H561340 | 01 |
| OH | MEDICAID GROUP | 0105065 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 310 S Cable Rd, Lima, OH 458053110 | 4192281000 | 4192273085 |
| 4 Eagle Dr Ste B, Minster, OH 458659714 | 4193947314 | 4193947314 |
| 4463 State Route 66 Ste B, Minster, OH 458658727 | 4193947314 | 4193947313 |
| 801 Pro Dr Ste D3, Celina, OH 458223307 | 4193947314 | 4193947313 |
| 812 Redskin Train, Suite B, Wapakoneta, OH 45895 | 4193947314 | 4193947313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699938621 | Jacqueline Susann Shriver | Audiologist-Hearing Aid Fitter | 4165 Hospital Dr Ne, Covington, GA 30014-2565 | 2008-07-09 |
| Street Address |
1067 HAGER ST GRAND LAKE OB/GYN |
| City | SAINT MARYS |
| State | OH |
| Zip Code | 45885-2422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568461051 | Mitchell E Nutt | Obstetrics & Gynecology | 1067 Hager St, Grand Lake Ob/gyn, Saint Marys, OH 45885-2422 | 2005-07-18 |
| 1861011827 | Kayla Albers | Physical Therapist | 1067 Hager St, Saint Marys, OH 45885-2422 | 2020-04-10 |
| 1255894598 | Marianne Ruth Voigt | Advanced Practice Midwife | 1067 Hager St, Saint Marys, OH 45885-2422 | 2019-04-12 |
| 1528573599 | Sara Lynn Gerlach | Nurse Practitioner | 1067 Hager St, Saint Marys, OH 45885 | 2017-12-12 |
| 1962882449 | Kelly A. Wilkinson | Advanced Practice Midwife | 1067 Hager St, Grand Lake Ob/gyn, Saint Marys, OH 45885-2422 | 2015-06-01 |
| 1659492916 | Polly Fleet Train | Obstetrics & Gynecology | 1067 Hager St, Dba: Grand Lake Ob/gyn, Saint Marys, OH 45885-2422 | 2007-04-03 |
| 1902923980 | Eyra A Agudu | Obstetrics & Gynecology | 1067 Hager St, Saint Marys, OH 45885-2422 | 2007-03-23 |
| 1497780233 | Bridget E Heckler | Advanced Practice Midwife | 1067 Hager St, Grand Lake Ob/gyn, Saint Marys, OH 45885-2422 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083232417 | Dimensional Wellness LLC | Counselor | 150 1/2 E. High St., Saint Marys, OH 45885 | 2020-07-13 |
| 1124679519 | Wishing Well Clinic & Spa, LLC | Massage Therapist | 153 E, Spring Street, St Marys, OH 45885 | 2019-09-26 |
| 1720633639 | Grand Lake Operations, LLC | Assisted Living Facility | 1035 Hager Street, Saint Marys, OH 45885 | 2019-08-07 |
| 1225436439 | Sharon Schnell | Pharmacist | 200 St. Clair Ave, St. Marys, OH 45885 | 2014-12-22 |
| 1851692669 | Gregory J Walter | Pharmacist | 1052 E. Spring St., St. Marys, OH 45885 | 2010-11-10 |
| 1578708053 | St Marys City Board of Education | Local Education Agency (LEA) | 2250 State Route 66, Saint Marys, OH 45885 | 2008-12-11 |
| 1104098037 | Alliance for Women's Health Inc | Obstetrics & Gynecology | 510 East Spring Street, St Marys, OH 45885 | 2008-04-01 |
| 1598869646 | Pajka Eye Center Inc | Ophthalmology | 200 St Clair, Joint Township District Memorial Hospital, St Marys, OH 45885 | 2006-09-11 |
| 1487664306 | Chalasani Md Inc. | Internal Medicine | 1300 Greenville Rd., St. Marys, OH 45885 | 2006-08-09 |
| 1821007949 | Kenneth Lance Bryant | Surgery | 1300 Greenville Rd Ste B, Saint Marys, OH 45885 | 2006-08-07 |
| Find all providers in zip 45885 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922648724 | Erin Mary Mcmahon | Nurse Practitioner | 761 Johnsonburg Rd, Saint Marys, PA 15857-3483 | 2020-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384790 | Kimberly Chmielewski | Nurse Practitioner | 3422 Cross Creek Cir, Wooster, OH 44691-1861 | 2020-10-21 |
| 1649877077 | Lee Danielle Watts | Nurse Practitioner | 2152 E State Route 29, Urbana, OH 43078-9779 | 2020-10-08 |
| 1003425281 | Jessica Shattuck | Nurse Practitioner | 108 Slippery Rock Ln, Berea, OH 44017-3155 | 2020-07-23 |
| 1205460060 | Katherine Niles | Nurse Practitioner | 7884 Oak Valley Rd, Reynoldsburg, OH 43068-1577 | 2020-03-02 |
| 1447803267 | Amy Kathleen Mock | Nurse Practitioner | 575 Westar Xing Ste 102, Westerville, OH 43082-7815 | 2019-07-21 |
| 1659933729 | Ashley Marie Brown | Nurse Practitioner | 2055 Crocker Rd Ste 206, Westlake, OH 44145-2197 | 2019-06-28 |
| 1144881772 | Erin Burris | Nurse Practitioner | 201 5th St Ne Ste 15, Barberton, OH 44203-3017 | 2019-06-25 |
| 1326604299 | Tiffany Messerall | Nurse Practitioner | 1577 Guilford Rd, Columbus, OH 43221-3850 | 2019-05-15 |
| 1093298689 | Jennifer Emrick | Nurse Practitioner | 3909 Orange Pl Ste 4400, Beachwood, OH 44122-4482 | 2018-09-11 |
| 1730661703 | Lisa Taormina-dingman | Nurse Practitioner | 7067 Tiffany Blvd Ste 220, Poland, OH 44514-1981 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT MARYS |
| Zip Code | 45885 |
Please comment or provide details below to improve the information on MRS. JACQUELINE S SHRIVER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.