Lauren Eileen Shade

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP61553983 Issued in WA

Practice address

1959 NE Pacific St
Seattle, WA 98195-0001

Phone

(425) 749-9511

NPI assigned

Jul 24, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  NPD (past)
• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1134809155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N 88TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981032131",
            "telephone_number": "425-749-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "425-749-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADE",
        "first_name": "LAUREN",
        "middle_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-05-01",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60918239",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP61553983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nordia Shackelford, LICSW
• Emily Anne Shackelton, D.D.S
• Erika A Sherman Shackleford, CDPT
• Sophia Shaddy, M.D.
• Erin D. Shade, PA-C
• Christina Phyllis Shadle
• Michael Neil Shadlen, M.D., PH.D.
• Mazyar Shadman, MD,MPH
• Ramin Shadman, M.D.
• Shafeena Chatur DDS

• Pediatric Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatric Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.