Shannon Berry, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD173846 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-7500

Fax

(503) 494-4997

NPI assigned

Mar 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbia Lutheran Charities

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1134146939
  Medicare reassignment NPD
• Columbia Lutheran Charities

  • Surgery Physician
  • Astoria, OR
  • NPI 1821254129
  Medicare reassignment NPD
• Columbia Lutheran Charities

  • Medical Specialty Clinic/Center
  • Astoria, OR
  • NPI 1902062672
  NPD
• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  NPD
• Columbia Lutheran Charities

  • Community Based Hospice Care Agency
  • Astoria, OR
  • NPI 1023038858
  NPD (past)
• Columbia Lutheran Charities

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1932814704
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205253267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7500",
            "fax_number": "503-494-4997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 Exchange St",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971033329",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD173846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liora Berry
• Mellissa Berry
• Michael Barnard Berry, MD
• Michelle Berry
• Samantha Berry, PHARMD
• Stacey M Berry, PSY.D.
• Stacey Warren Berry, APRN
• Tracey I. Berry, MD
• Tresa Berry, PPS
• Tricia Deaton Berry, LCSW, MSW

• Emergency Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.