SHANA LYNETTE MUNDY NPI 1023605862

NPI Information

NPI: 1023605862
Provider Name: SHANA LYNETTE MUNDY
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Individual
Address:
345 LARCHMONT AVE
SPRINGFIELD, OH
ZIP 45503
Phone: (937) 631-5017
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Shana Lynette Mundy is a preferred provider organization in Springfield, OH. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. Shana Lynette Mundy NPI is 1023605862. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

345 LARCHMONT AVE
SPRINGFIELD, OH
ZIP 45503-423
Phone: (937) 631-5017

The enumeration date for this NPI number is 12/28/2020 and was last updated on 12/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	305R00000X	Preferred Provider Organization				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1203629	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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