Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1265132211 Individual Practitioner Male Practitioner

Jacob Michael Shelley , CDCA, CPRS

Peer Specialist • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Jacob Shelley, CDCA, CPRS is a registered healthcare professional specializing in Peer Specialist in Dayton, OH. Practice services are available at 343 TROY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

343 Troy St

Dayton, OH 454041830

Telephone 9379491524
Associated Practice Facility / Clinic
🏢 Sidewalk Soldiers Facility NPI 1477261683

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.5 Yrs
Regional Practice Density
179 Specialists

Practicing in Dayton, OH (3139 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-30
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OH APS.003608

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH CDCA.187249

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Katie Tackett

Peer Specialist

NPI 1053966168
Jason Johnson

Peer Specialist

NPI 1417820796
Emily Kinzing

Peer Specialist

NPI 1437085974
Amy Muran

Peer Specialist

NPI 1467251561
NPI 1467379586

MASW, OCPS, Licensed Master Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location October 30, 2025

Registered at 343 TROY ST, DAYTON, OH 454041830 (Tel: 9379491524)

📍
Updated Business Mailing Address October 30, 2025

Registered at 343 TROY ST, DAYTON, OH 454041830

👤
Provider Name / Credentials Updated October 30, 2025

Recorded as JACOB SHELLEY, CDCA/CPRS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 30, 2025

Peer Specialist (License #APS.003608 in OH)

NPI Profile Active March 08, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 08, 2023

Registered at 2960 W ENON RD, XENIA, OH 453858548 (Tel: 9372724925)

📍
Updated Business Mailing Address March 08, 2023

Registered at 2960 W ENON RD, XENIA, OH 453858548 (Tel: 9372724925)

👤
Provider Name / Credentials Updated March 08, 2023

Recorded as JACOB SHELLEY, CDCA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 08, 2023

Counselor (License #CDCA.183560 in OH)

🟢
Initial NPI Registration & Enumeration March 08, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jacob Shelley. Be the first to share your experience!

Sign in to leave a review for Jacob Shelley

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1265132211
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 08, 2023
Last Update: October 30, 2025
Sole Proprietor: No

Mailing Address

343 Troy St

Dayton, OH 454041830

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.