Shannon Kay Mortensen, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

N-31561 Issued in ID

Practice address

2288 Merritt Creek Loop
Coeur D'Alene, ID 83814

Phone

(208) 665-7546

Fax

(208) 667-4607

NPI assigned

Oct 2, 2006

Last updated

Feb 5, 2009By 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 1

Addresses

Other identifiers 1

Other names 1

• Shannon Kay Armstrong Former name

Medicare fee-for-service enrollment

Enrolled in ID

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Idaho Dermatology IncGroup PAC ID 2365404431, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gritman Medical Center Hospital, Moscow, ID, CCN 131327
• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

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.

• North Idaho Dermatology, Inc.

  • Dermatology Physician
  • Coeur d'Alene, ID
  • NPI 1215936638
  Medicare reassignment Care Compare group
• St Josephs Ear Nose and Throat Clinic PLLC

  • Specialist
  • Post Falls, ID
  • NPI 1952355539
  NPD (past)

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

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Care Compare affiliation
• Gritman Medical Center Inc.

  dba Gritman Internal Medicine Clinic

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590

  Hospital

  Care Compare affiliation
• Public Hospital District #1-a of Whitman County

  dba Pullman Regional Hospital

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1104919695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 MERRITT CREEK LOOP",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-665-7546",
            "fax_number": "208-667-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 MERRITT CREEK LOOP",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-665-7546",
            "fax_number": "208-667-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "SHANNON",
        "middle_name": "KAY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N-31561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806523200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "ARMSTRONG",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Scott Morrison, ATC, LAT
• Stephanie Alyse Morrison, PT
• Elizabeth Morrissette, OTR
• Kylee Morrow
• Sara Bryn Morrow, PH.D.
• Kent E Mosby, DDS
• Charles W Moseley, CRNA
• Annie M Moser Allen, APRN
• Natasha Mosley
• Eric Nuneza Mosqueda, M.D.

• Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.