NPIMap

Individual provider Active NPI

Shannon Scriven

  • Clinical Medical Laboratory
  • Bend, OR
National Provider Identifier
1184046237
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
1420 NE Mable CT
Bend, OR 97701-3722
Phone
(541) 680-2001
NPI assigned
Jan 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary
Phlebotomy Technician 246RP1900X

Addresses

Primary practice location

1420 NE Mable CT
Bend, OR 97701-3722

Mailing address

1420 NE Mable CT
Bend, OR 97701-3722
Phone (541) 680-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Mobile Phlebotomy Services, LLC Clinical Medical Laboratory Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1184046237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 NE MABLE CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013722",
            "telephone_number": "541-680-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 NE MABLE CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013722",
            "telephone_number": "541-680-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRIVEN",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.