Individual provider Active NPI

Shoshana Elise Brown, CNM

  • Advanced Practice Midwife
  • Everett, WA
National Provider Identifier
1194363416
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP61352551 Issued in WA
Practice address
4526 Federal Ave
Everett, WA 98203-2132
Phone
(425) 349-6200
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60967512 WA
Advanced Practice Midwife 367A00000X AP61352551 WA Primary

Addresses

Primary practice location

4526 Federal Ave
Everett, WA 98203-2132

Mailing address

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Other practice location 1

11511 NE 10th St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Other names 1

  • Shoshana Elise Dickerson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206002519 WA Practitioner - Certified Nurse Midwife (CNM) 8022467711 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN60967512WAMDRegistered Nurse
AP61352551WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 30, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 30, 2023 Accepting new patients

Locations

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: sdickerson4318507@ghc.direct-ci.net

Organizations & group practices 2

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": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1194363416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000",
            "fax_number": "844-620-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11511 NE 10th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980048578",
            "country_code": "US",
            "telephone_number": "425-502-3000",
            "fax_number": "844-620-1839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHOSHANA",
        "middle_name": "ELISE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60967512",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61352551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHOSHANA",
            "last_name": "DICKERSON",
            "middle_name": "ELISE",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.