Individual provider Active NPI

Shelanna Rae Burton

  • Community Health Worker
  • Bend, OR
National Provider Identifier
1043825490
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
2200 NE Professional CT
Bend, OR 97701-6063
Phone
(541) 389-6313
Fax
(541) 389-8760
NPI assigned
Sep 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

2200 NE Professional CT
Bend, OR 97701-6063

Mailing address

2200 NE Professional CT
Bend, OR 97701-6063
Phone (541) 389-6313

Other practice location 1

61250 SE Coombs Pl
Bend, OR 97702-3704
Phone (541) 389-6313

Other practice location 2

760 NW York Dr
Bend, OR 97703-7125
Phone (541) 389-6313

Other practice location 3

413 NW Larch Ave
Redmond, OR 97756-1396
Phone (541) 389-6313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1043825490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NE PROFESSIONAL CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016063",
            "telephone_number": "541-389-6313",
            "fax_number": "541-389-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE PROFESSIONAL CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016063",
            "telephone_number": "541-389-6313",
            "fax_number": "541-389-8760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61250 SE Coombs Pl",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023704",
            "country_code": "US",
            "telephone_number": "541-389-6313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 NW York Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977037125",
            "country_code": "US",
            "telephone_number": "541-389-6313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "413 NW Larch Ave",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977561396",
            "country_code": "US",
            "telephone_number": "541-389-6313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURTON",
        "first_name": "SHELANNA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.