Individual provider Active NPI

Faith Renee Shinn, FNP-C

  • Family Nurse Practitioner
  • Dallas, OR
National Provider Identifier
1023516614
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201800533NP-PP Issued in OR
Practice address
531 SE Clay St
Dallas, OR 97338-2865
Phone
(971) 612-6100
Fax
(971) 612-6101
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201800533NP-PP OR Primary

Addresses

Primary practice location

531 SE Clay St
Dallas, OR 97338-2865

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180208001033 OR Practitioner - Nurse Practitioner 5395005599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

531 SE Clay St
Dallas, OR 97338-2865
Phone (971) 612-6100

Hospital & facility affiliations

  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201800533NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Family CurrentSince Sep 1, 2021 Accepting new patients
Praxis Health, PC CurrentSince Sep 1, 2021 Accepting new patients

Locations

531 SE Clay St
Dallas, OR 97338
Phone (503) 623-5430

4999 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 364-4005

Interoperability endpoints

  • Direct secure messaging: dallasfamilycare@praxismedicalgroup.directbygreenway.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1023516614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 SE CLAY ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382865",
            "telephone_number": "971-612-6100",
            "fax_number": "971-612-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINN",
        "first_name": "FAITH",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201800533NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

Verify at the official NPI Registry.