Active NPI
Shirley M Pryor, ARNP
- Nurse Practitioner
- Ilwaco, WA
National Provider Identifier
1083601264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30003770
- Practice address
- 176 1St Ave N
PO Drawer N
Ilwaco, WA 98624 - Phone
- (360) 642-3747
- Fax
- (360) 642-3361
- NPI assigned
- Oct 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30003770 | WA | Primary |
Addresses
Primary practice location
176 1St Ave N
PO Drawer N
Ilwaco, WA 98624
Mailing address
176 1St Ave N
PO Drawer N
Ilwaco, WA 98624
Phone (360) 642-3747
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9616582 | Medicaid | WA | |
| PR8034 | Other | WA | BCBS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372291200000",
"number": "1083601264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176 1ST AVE N",
"address_2": "PO DRAWER N",
"city": "ILWACO",
"state": "WA",
"postal_code": "98624",
"telephone_number": "360-642-3747",
"fax_number": "360-642-3361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 1ST AVE N",
"address_2": "PO DRAWER N",
"city": "ILWACO",
"state": "WA",
"postal_code": "98624",
"telephone_number": "360-642-3747",
"fax_number": "360-642-3361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "SHIRLEY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-03",
"last_updated": "2013-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30003770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9616582",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "PR8034",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ilwaco, WA
- Jacob Owings, PHARMD
- Pacific Heart Associates PC
- Peninsula Pharmacies Inc
- Peninsula Pharmacies Inc.
- Providence Health & Services - Oregon
- Public Hospital District 3 of Pacific County
- Public Hospital District 3 of Pacific County
- Public Hospital District 3 of Pacific County
- Public Hospital District 3 of Pacific County
- Tracy Renee Ramos, PA-C, ATC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.