Active NPI 1215380423 Individual Practitioner Female Practitioner

Addie Shock

Nurse Practitioner - Pediatrics • Elyria, OH

Professional Overview & Biography Verified Profile Summary

Addie Shock is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Elyria, OH. Practice services are available at 125 E BROAD ST STE 302 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

125 E Broad St Ste 302

Elyria, OH 440356447

Telephone 4403230258

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Elyria, OH

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 32.0 Yrs

State Avg: 12.0 Yrs

Regional Practice Density

2 Specialists

Practicing in Elyria, OH (1102 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: 2022-03-29

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License OH RN3810151

Definition to come...

Practice Associates & Co-Workers

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

1 Associated Practitioners

Dr. Carmen Hansford , MD

Pediatrics

NPI 1902868086

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location March 29, 2022

Registered at 125 E BROAD ST STE 302, ELYRIA, OH 440356447 (Tel: 4403230258)

📍

Updated Business Mailing Address March 29, 2022

Registered at 9807 NICOLE LN, OLMSTED TWP, OH 441384252 (Tel: 4196854353)

✅

NPI Profile Active July 22, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 22, 2016

Registered at 282 BENEDICT AVE STE B, NORWALK, OH 448572712 (Tel: 4196689409)

📍

Updated Business Mailing Address July 22, 2016

Registered at 282 BENEDICT AVE STE B, NORWALK, OH 44857 (Tel: 4196689409)

👤

Provider Name / Credentials Updated July 22, 2016

Recorded as ADDIE SHOCK

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2016

Nurse Practitioner (License #RN3810151 in OH)

🟢

Initial NPI Registration & Enumeration July 22, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215380423

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 22, 2016

Last Update: March 29, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

9807 Nicole Ln

Olmsted Twp, OH 441384252

Phone: 4196854353

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.