Jennifer Shockley
Nurse Practitioner (Family)

Address: 630 E River St, Elyria, OH 44035-5902
Phone: 4403297500

Jennifer Shockley (NPI# 1588034656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1588034656
Entity Type Individual
Full Name Jennifer Shockley
Credential FNP-C
Gender Female
Practice Address 630 E River St
Elyria
OH 44035-5902
Practice Telephone 4403297500
Mailing Address 2463 Fairfield Dr
Avon
OH 44011-4769
Mailing Telephone 8434411148
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2015-10-02
Last Update Date 2015-10-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LF0000X Nurse Practitioner · Family Physician Assistants & Advanced Practice Nursing Providers COA.18095-NP OH

Other Providers JENNIFER SHOCKLEY

NPI Name Taxonomy Address Enumeration
1205191723 Jennifer J Shockley Licensed Practical Nurse 9503 State Route 350, Clarksville, OH 45113-9447 2012-07-10
1740248103 Jennifer S Shockley Nurse Anesthetist, Certified Registered 216 Olive Branch Rd, Nashville, TN 37205-3220 2006-05-03
1336139658 Jennifer A Shockley Family Medicine 115 Bridge St, Elk Rapids, MI 49629-5110 2005-10-27

Physician Overview

NPI 1588034656
PAC ID by PECOS 0446569750
Professional Enrollment ID I20151027000672
Full Name Jennifer L Shockley
Organization Legal Name LORAIN COUNTY HEALTH AND DENTISTRY
Phone Number 4402401655
Gender F
Graduation Year 2015
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 9234047853
Number of Group Practice Members 3
Accepts Medicare Assignment Y
Report Quality Measures Y

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_47_1 Advance Care Plan 2%

Office Location

Street Address 630 E RIVER ST
City ELYRIA
State OH
Zip Code 44035-5902

Providers in the same location

NPI Name Taxonomy Address Enumeration
1841299039 Emh Regional Medical Center General Acute Care Hospital 630 E River St, Elyria, OH 44035-5902 2005-07-19
1063984623 Kimberly Lynn Horvath Nutritionist 630 E River St, Elyria, OH 44035-5902 2018-12-20
1003387051 Jessica Anne Mikelait Nurse Anesthetist, Certified Registered 630 E River St, Elyria, OH 44035-5902 2018-12-16
1457836405 Jennifer Anne Mize Nurse Practitioner 630 E River St, Elyria, OH 44035-5902 2018-09-26
1376027243 Allison M Plas Nurse Anesthetist, Certified Registered 630 E River St, Elyria, OH 44035-5902 2018-09-18
1902301120 Elizabeth Leona Clark Nurse Practitioner 630 E River St, Elyria, OH 44035-5902 2018-03-28
1982127940 Joseph Anthony Constantino Nurse Anesthetist, Certified Registered 630 E River St, Elyria, OH 44035-5902 2017-07-21
1942738620 Miah Daiello Physician Assistant 630 E River St, Elyria, OH 44035-5902 2017-05-25
1245778257 Monica Sparks Physician Assistant 630 E River St, Elyria, OH 44035-5902 2017-02-09
1336691963 Rachel Jones Nurse Practitioner 630 E River St, Elyria, OH 44035-5902 2016-10-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548788151 Robin Lee Newhart Physical Therapist 1885 Lake Avenue, Elyria, OH 44035 2017-09-03
1174073688 Kimberly Duncan Social Worker 4615 Oakhill Blvd, Condo #205, Lorain, OH 44035 2016-10-07
1679027585 Signature Smiles Dr. Salameh, LLC Dentist 570 Chestnut Commons Dr., Elyria, OH 44035 2016-08-09
1124438791 Ann Pecsok Physical Therapist 42101 Griswold Rd., Elyria, OH 44035 2014-05-05
1346589066 Catherine M Hollan Licensed Practical Nurse 39020 Chestnut Ridge Road, Elyria, OH 44035 2013-02-01
1639413453 Elyria Mediclinic Clinic/Center 156 Cleveland Street, Elyria, OH 44035 2012-11-16
1194078717 Douglas Joseph Sherlock Obstetrics & Gynecology 125 E Broad Street, Ste 218, Elyria, OH 44035 2012-10-19
1881956670 Supriya Marie Mahajan Psychiatry & Neurology 673 East River Street, Elyria, OH 44035 2012-06-08
1790043222 Patricia J Cathcart Nurse Practitioner 10325 Dewhurst, Elyria, OH 44035 2012-05-03
1417249558 Jrayene Nimene Social Worker 5525 Abbe Road, Elyria, OH 44035 2011-05-09
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come…

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568937324 Marianne Jeanette Parker Nurse Practitioner 134 Buckingham Dr, Elyria, OH 44035-1706 2018-10-09
1003384207 Leslie A Strodtbeck Nurse Practitioner 1120 E Broad St, Elyria, OH 44035-6306 2018-11-06
1457836405 Jennifer Anne Mize Nurse Practitioner 630 E River St, Elyria, OH 44035-5902 2018-09-26
1437698743 Niki Virginia Smiley Wilson Nurse Practitioner 1120 E Broad St, Elyria, OH 44035-6306 2017-02-20
1487109724 Ekaterina Kholyavka Nurse Practitioner 1120 E Broad St, Elyria, OH 44035-6306 2016-08-16
1548389844 Kathryn Meyer Nurse Practitioner 602 Leona St, Elyria, OH 44035-2404 2007-03-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1598223414 Jeanni A. Gerwin Nurse Practitioner 6940 Woody Ct, Canal Winchester, OH 43110-9645 2019-03-10
1962960906 Jessie Liyi Peng Nurse Practitioner 32047 Hamilton Ct Apt 208, Solon, OH 44139-5722 2019-03-08
1871051037 Allison Bottorff Nurse Practitioner 1171 Academy Dr, Youngstown, OH 44505-1621 2019-03-06
1518425701 Cynthia Lynn Taylor Nurse Practitioner 3009 Smith Rd Ste 200, Fairlawn, OH 44333-2670 2019-03-06
1225596570 Trisha D Hamm Nurse Practitioner Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 2019-03-06
1447718747 Lauren Whitney Studer Nurse Practitioner 1721 Medical Blvd Ste C, Findlay, OH 45840-1354 2019-03-05
1306304993 Nathan Ware Nurse Practitioner 13589 Forest Dr, Marshallville, OH 44645-9748 2019-03-04
1497213011 Laurel Ann Jones Nurse Practitioner 1123 Mallow Rd Ne, Minerva, OH 44657-9752 2019-03-04
1174081657 Heather I Prince Nurse Practitioner 1048 Mccoy Ct, Pataskala, OH 43062-7098 2019-03-04
1598222127 Penny B Drazer Nurse Practitioner 8290 Old Troy Pike, Huber Heights, OH 45424-1056 2019-03-01
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Competitor

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City ELYRIA
Zip Code 44035

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Dataset Information

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.

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