Shamyne Hover Dumouchel, FNP

Key facts

NPI

1164708103

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

NUR-APRN-LIC-174670 (MT)

Practice address

106 Ridgewater Dr Ste a
Polson, MT 59860-8977

Phone

(406) 752-7441

Fax

(406) 257-0304

NPI assigned

Oct 21, 2011

Sex

Female

Sole proprietor

No

Organizations & group practices 10

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.

• Kalispell Regional Medical Center Inc General Acute Care Hospital · Kalispell, MT · NPI 1417945627
  Medicare reassignment Care Compare group NPD MT
• Kalispell Regional Medical Center, Inc Radiology Clinic/Center · Whitefish, MT · NPI 1073362463
  Care Compare group NPD
• Kalispell Regional Medical Center Inc Ambulatory Surgical Clinic/Center · Polson, MT · NPI 1548626872
  Care Compare group
• Kalispell Regional Medical Center Inc Community Based Hospice Care Agency · Kalispell, MT · NPI 1811062524
  Care Compare group
• Kalispell Regional Medical Center, Inc Home Health Agency · Kalispell, MT · NPI 1023183720
  Care Compare group
• Kalispell Regional Medical Center, Inc Clinic/Center · Kalispell, MT · NPI 1093477176
  Care Compare group
• Kalispell Regional Medical Center, Inc Ambulatory Surgical Clinic/Center · Kalispell, MT · NPI 1912945544
  Care Compare group
• Glacier Regional Pathology, LTD. Anatomic Pathology Physician · Kalispell, MT · NPI 1619081767
  NPD
• Kalispell Regional Medical Center Inc Clinic/Center · Kalispell, MT · NPI 1184949885
  NPD
• Kalispell Regional Medical Center Inc Clinic/Center · Kalispell, MT · NPI 1235333139
  NPD

Hospital & facility affiliations 9

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

• Kalispell Regional Medical Center Inc Surgical Oncology Physician · Kalispell, MT · NPI 1053790063
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc Maternal & Fetal Medicine Physician · Kalispell, MT · NPI 1053798710
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc General Acute Care Hospital · Kalispell, MT · NPI 1417945627
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc Hospice and Palliative Medicine (Family Medicine) Physician · Kalispell, MT · NPI 1477989770
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc Nephrology Physician · Kalispell, MT · NPI 1700277837
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc Hematology & Oncology Physician · Kalispell, MT · NPI 1891151122
  Care Compare affiliation Hospital
• Kalispell Regional Medical Center Inc Obstetrics & Gynecology Physician · Kalispell, MT · NPI 1972982981
  Care Compare affiliation Hospital
• Providence St Joseph Medical Center Critical Access Hospital · Polson, MT · NPI 1821184888
  Care Compare affiliation Hospital
• St Lukes Community Hospital Critical Access Hospital · Ronan, MT · NPI 1336213446
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kalispell Regional Medical Center Inc (422 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Logan Health Medical Center Hospital · Kalispell, MT · CCN 270051
• Providence St Joseph Medical Center Hospital · Polson, MT · CCN 271343
• St Luke Community Hospital Hospital · Ronan, MT · CCN 271325

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 27, 2021.

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1164708103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 RIDGEWATER DR STE A",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608977",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Ridgewater Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598608977",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Whitewater Pl Ste C",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598604502",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUMOUCHEL",
        "first_name": "SHAMYNE",
        "middle_name": "HOVER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21349",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-174670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "106 Ridgewater Dr Ste A",
            "city": "Polson",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598608977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "106 Ridgewater Dr Ste B",
            "city": "Polson",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598608977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "103 Whitewater Pl Ste C",
            "city": "Polson",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598604502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Polson, MT

• Dr. Vincent River, P.C.
• Ken Druyvestein, RPH
• Lesley E. Dubay, LAC
• Elizabeth Duckworth
• Michael Lucian Dumouchel, DNP, CRNA, NSPM-C
• Stacey Jo Dunn, PHD
• Jerome Dunst, M.D.
• Hannah Dupea, MD
• Derrek Durocher, DC
• Jesse Rae Durocher, DC

All providers in Polson, MT · Family Nurse Practitioner in Montana