Healthcare Provider Details

I. General information

NPI: 1881501260
Provider Name (Legal Business Name): CASSADY SHULTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W 10TH AVE
COLUMBUS OH
43210-1328
US

IV. Provider business mailing address

180 WEST AVE
PLAIN CITY OH
43064-1137
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-5000
  • Fax:
Mailing address:
  • Phone: 614-301-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberTW668897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: