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NPI Code Detail

MEDICARE: DR. JENNIFER LYNN SHOENFELT M.D.

MEDICARE: DR. JENNIFER LYNN SHOENFELT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician090873OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2SH7387391OTHEROHMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659562965
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER LYNN SHOENFELT M.D.
Provider Business Mailing Address
First Line : 1 W WINTER ST STE 200
Second Line :
City : DELAWARE
State : OH
Zip : 43015-4635
Country : US
Telephone Number : 513-828-0285
Fax Number : 888-815-3583
Provider Business Practice Location Address
First Line : 1 W WINTER ST STE 200
Second Line :
City : DELAWARE
State : OH
Zip : 43015-4635
Country : US
Telephone Number : 513-828-0285
Fax Number : 888-815-3583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 12/30/2025

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