Individual provider Active NPI

Shaylyn B Murphy, PA-C

  • Physician Assistant
  • The Dalles, OR
National Provider Identifier
1164404786
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00919 Issued in OR
Practice address
1620 E 12TH St
The Dalles, OR 97058
Phone
(541) 296-9151
Fax
(541) 296-9156
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00919 OR Primary

Addresses

Primary practice location

1620 E 12TH St
The Dalles, OR 97058

Mailing address

1620 E 12TH St
PO Box 1520
The Dalles, OR 97058
Phone (541) 296-9151

Other identifiers 1

IdentifierTypeStateIssuer
218112MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20040123000432 OR Practitioner - Physician Assistant 4385546068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

1620 E 12TH St
The Dalles, OR 97058-3213
Phone (541) 296-9151

551 Lone Pine Blvd
The Dalles, OR 97058-9404

PO Box
The Dalles, OR 97058

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Aug 1, 2003 Accepting new patients
Mid-Columbia Medical Center Physician Assistant CurrentSince Aug 1, 2003 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1730 E 12th St
The Dalles, OR 97058
Phone (541) 296-5411

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

Interoperability endpoints

  • Direct secure messaging: smurphy38602@direct.ohsu.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1164404786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "address_2": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "97058",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "97058",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "SHAYLYN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218112",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.