Shannon Carey
Individual provider Active NPI Physician Assistant · Portland, OR
NPI 1154700219 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1154700219
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA179831 (OR)
- Practice address
- 3181 SW Sam Jackson Park Rd
Gh219
Portland, OR 97239-3011 - Phone
- (503) 494-3633
- NPI assigned
- May 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Human Services Inc
Practice addresses (Care Compare)
1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526
Hospital & facility affiliations
- Salem Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170327001137 | OR | Practitioner - Physician Assistant | 2567747918 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA179831 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Human Services, Inc. | Current |
Accepting new patients | |
| Northwest Human Services, Inc. | Current |
Accepting new patients |
Locations
180 Atwater St N
Monmouth, OR 97361
Phone (503) 378-7526
1233 Edgewater St NW
#219
Salem, OR 97304
1233 Edgewater St NW
Salem, OR 97304
Phone (503) 378-7526
Interoperability endpoints
- shannon.carey.p1@direct.nwhumanservices.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA179831 | OR | Yes |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Gh219
Portland, OR 97239-3011
Mailing address
1233 Edgewater St NW
Gh219
Salem, OR 97304-4049
Phone (503) 378-7526
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | shannon.carey.p1@direct.nwhumanservices.nextgenshare.com | Direct | Northwest Human Services, Inc. |
Other providers in Portland, OR
- James David Carey
- Jennifer Lynn Carey
- Julie Malcom Carey
- Marc B Carey
- Reginald Allan Carey
- Yela Carey
- Zane Carey
- Matt Carges
- Carie Arps LPC LLC
- Caring for Community
All providers in Portland, OR · Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.