Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Allen Shattuck Sr.

Individual provider Peer Specialist · NPI 1619818333

Jacob Allen Shattuck Sr. is a Peer Specialist in Columbus, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2026

Practice location Address checks out

211 S 5th St
Columbus, OH 43215-5203
Phone: (614) 567-6274
Fax: (855) 604-0927
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence PRS.007652 (OH)

Record details

NPI number1619818333
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 6, 2026
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

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