Shannon Marie Williams, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60730481 Issued in WA

Practice address

1412 Clarence Ave
Walla Walla, WA 99362-7246

Phone

(503) 927-8521

NPI assigned

Jan 26, 2015

Last updated

Jun 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Merit-based Incentive Payment System (MIPS)

Final score

28.88 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

96.26

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Williams Enterprises LLC

  • Internal Medicine Physician
  • Walla Walla, WA
  • NPI 1467312207
  Medicare reassignment NPD Authorized official
• Choice Family Medicine LLC

  • Adult Medicine Physician
  • Walla Walla, WA
  • NPI 1275057655
  Medicare reassignment

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1073903357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 CLARENCE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993627246",
            "telephone_number": "503-927-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60730481",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200642784RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Ellsworth Willard, MD
• William BL Murdoch DDS
• Williams Enterprises LLC
• Amanda Leslie Williams, HIS, AAS
• Chrstine Williams, CPC
• Tasha Willoughby
• Levi David Wilson, MA
• Wendy Wilson
• Jessica Winarto
• Brent E Winterbottom, PT, DPT

• Nurse Practitioner in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.