Kimberly Susan Shotz, WHCNP, LAC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

OR 093006979N7 Issued in OR

Practice address

736 SE 60TH Ave
Portland, OR 97215-1906

Phone

(971) 645-4009

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kim Shotz Other name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Project QuestGroup PAC ID 3971490970, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
• WA PPO C-SNP

Interoperability endpoints

• Direct secure messaging: kshotz1130080@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Project Quest

  • Addiction (Substance Use Disorder) Counselor
  • Portland, OR
  • NPI 1144250168

  Acupuncturist

  Medicare reassignment Care Compare group NPD
• The Oregon Clinic PC

  • Specialist
  • Portland, OR
  • NPI 1265417174
  Medicare reassignment NPD
• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD
• Project Quest

  • Specialist
  • Portland, OR
  • NPI 1134458052
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1003908120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 SE 60TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151906",
            "telephone_number": "503-318-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 SE 60TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151906",
            "telephone_number": "971-645-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTZ",
        "first_name": "KIMBERLY",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "WHCNP, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "OR 093006979N7",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC156829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "SHOTZ",
            "credential": "WHCNP-BC, RN, LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melody Lynne Short, L.AC.
• Walter Short
• Grant Shortell
• Lisa Darya Shostak
• Lana Joy Shotwell Kubo, MA
• Hyuna Shou
• Anthony Shoukas
• Madison Shoukas
• Abbey Shoultz, MSW, LCSW
• Alyssa Marie Showalter

• Women's Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Women's Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.