SHASTA MITCHELL-HOLSTON (FNP-C) – Family Nurse Practitioner, NPI 1881004901

SHASTA MITCHELL-HOLSTON (FNP-C) is a healthcare provider. based in Avon, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 0024176097 (VA). The NPI Number for SHASTA MITCHELL-HOLSTON (FNP-C) is 1881004901

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
SHASTA MITCHELL-HOLSTON (FNP-C)
NPI
1881004901
Phone
(216) 526-2214
Address
36550 CHESTER RD
Enumeration Date
28 April 2014
Last Update Date
5 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7577732781
Graduation Year
2012 (14 years ago)
PAC ID
7214151067
Group Practice PAC ID
0446658736
Professional Enrollment ID
I20181003000866
Address ID
VA234353755SU1540XWAYX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for SHASTA MITCHELL-HOLSTON (FNP-C)

  • 36550 CHESTER RD

    5404

    AVON, OH 440111091

    Phone: (216) 526-2214

    Type: Mailing

  • 3636 HIGH ST

    PORTSMOUTH, VA 23707

    Phone: (757) 398-2285

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $449.

Total Amount is formed as General ($449) + Research ($0) + Ownership ($0) = $449.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Novo Nordisk Inc ($369).

Total Amount

$449

General + Research + Ownership

Payments

17

Total payment records

General Amount

$449

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-10-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181003000866INurse PractitionerVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44011)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446658736View full group profile
NameSpecialtyState
Nurse PractitionerVA

Reviews

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Frequently asked questions

Can I cross-check SHASTA MITCHELL-HOLSTON (FNP-C) using NPI 1881004901?
NPI 1881004901 belongs to SHASTA MITCHELL-HOLSTON (FNP-C); compare other details if you need extra assurance.
Would SHASTA MITCHELL-HOLSTON (FNP-C) appear as active to a payer?
You can treat SHASTA MITCHELL-HOLSTON (FNP-C) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is SHASTA MITCHELL-HOLSTON (FNP-C)?
SHASTA MITCHELL-HOLSTON (FNP-C) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for SHASTA MITCHELL-HOLSTON (FNP-C)?
Travel planning: use Avon, Ohio as the reference point for SHASTA MITCHELL-HOLSTON (FNP-C), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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