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SHINY GEORGE
NPI 1063003077
Nurse Practitioner - Family in Dayton, OH

Active since February 02, 2021PECOS Enrolled
1435 CINCINNATI ST, DAYTON, OH 45417(513) 941-4999(513) 694-0168 Get Directions Write a Review

NPPES record last updated: August 19, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 21, 2024, Apr 4, 2022, Mar 1, 2021 and 1 more (4 updates tracked since 2021).

About Shiny George NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHINY GEORGE (NPI 1063003077) is an individual family provider in Dayton, Ohio, licensed in Ohio (APRN.CNP.0028330) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and maintains 10 additional practice locations.

NPPES Registry Identity

NPI1063003077
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHINY GEORGE
Location Address1435 CINCINNATI STDayton, OH 45417-4614
Mailing Address6460 Harrison Ave Ste 200Cincinnati, OH 45247-7958 · (513) 941-4999 · Fax (513) 694-0168
Phone(513) 941-4999
Fax(513) 694-0168
Sole ProprietorNo
Enumeration DateFebruary 2, 2021
Last NPPES UpdateAugust 19, 20254 updates tracked since enumeration
NPPES CertifiedAugust 19, 2025
✔ NPI 1063003077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · APRN.CNP.0028330
Also ListedRegistered NurseTaxonomy 163W00000X · License RN.308675 (OH)
1435 CINCINNATI ST, Dayton, OH 45417
Open in Google Maps ↗

Secondary Practice Locations 10

Location 1680 Northland BlvdCincinnati, OH 45240-3248 · Phone (513) 941-4999
Location 26460 Harrison Ave Ste 200Cincinnati, OH 45247-7958 · Phone (513) 941-4999
Location 325 Whitney Dr Ste 122Milford, OH 45150-8400 · Phone (513) 941-4999
Location 41907 11th StPortsmouth, OH 45662-4531 · Phone (513) 941-4999
Location 5247 Cic BlvdWest Union, OH 45693-7512 · Phone (513) 941-4999
Location 61130 Garbry RdPiqua, OH 45356-8217 · Phone (513) 941-4999
Location 71421 Parker CtSpringfield, OH 45504-2855 · Phone (513) 941-4999
Location 8160 N Breiel BlvdMiddletown, OH 45042-3806 · Phone (513) 941-4999
Location 9100 Highview BlvdColumbus, OH 43207-6023 · Phone (513) 941-4999
Location 101718 Central PkwyCincinnati, OH 45214-2355 · Phone (513) 941-4999

Other Identifiers 1

Medicaid0434641OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shiny George is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shiny George reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sunrise Treatment Center, LLC
Same address
Rehabilitation, Substance Use Disorder
1435 CINCINNATI ST STE 150
Dayton, OH 45417
  • Reassigned Medicare billing, Ohio enrollment
  • 12 clinicians in this Medicare group
NPI 1639652084 (513) 941-4999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45417 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSIKA PUCKETT CDCA
Counselor (Addiction (Substance Use Disorder))
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (513) 941-4999
MRS. ABBY MICHELE RAPKING PA-C
Physician Assistant
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (937) 449-0800
ALISON L WATKINS
Counselor (Addiction (Substance Use Disorder))
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (513) 941-4999
JENNIFER FOLEY LSW
Counselor
1435 CINCINNATI ST, SUITE 100
DAYTON, OH 45417
Montgomery County (937) 449-0800
ZACHARY WALLER
Licensed Practical Nurse
1435 CINCINNATI ST, STE 100
DAYTON, OH 45417
Montgomery County (937) 449-0800
LENA MARIE WATSON
Licensed Practical Nurse
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (513) 941-4999
LATOYA MARIE SCANDRICK
Counselor (Addiction (Substance Use Disorder))
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (513) 941-4999
JENNIFER ROBINSON
Radiologic Technologist
1435 CINCINNATI ST
DAYTON, OH 45417
Montgomery County (937) 449-0800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shiny George's NPI number?

The NPI number for Shiny George is 1063003077. It was assigned to this individual provider in the NPPES registry on February 2, 2021.

Where is Shiny George located?

Shiny George practices at 1435 Cincinnati St, Dayton, OH 45417. The listed phone number is (513) 941-4999.

What is Shiny George's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shiny George enrolled in Medicare?

Yes. Shiny George is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shiny George's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shiny George reassigns Medicare benefits to Sunrise Treatment Center, LLC (Dayton, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shiny George's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shiny George accept?

Health plans from CareSource list Shiny George as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shiny George was last updated on August 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.