Individual provider Active NPI

Shawna Strouth-Shaw, NP

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1205335809
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
129177 Issued in AK
Practice address
320 Bawden St Apt 313
Ketchikan, AK 99901-6544
Phone
(907) 220-9982
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 129177 AK Primary

Addresses

Primary practice location

320 Bawden St Apt 313
Ketchikan, AK 99901-6544

Mailing address

PO Box 1512
Ward Cove, AK 99928-1512
Phone (907) 821-8073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20190328002690 AK Practitioner - Nurse Practitioner 0840530879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1225 Tongass Ave
Ketchikan, AK 99901-6182
Phone (907) 220-9982

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Family Health Clinic Inc Family CurrentSince Nov 8, 2018 Accepting new patients
Power of Wellness Health Services LLC PastSince Aug 1, 2019 Accepting new patients

Locations

320 Bawden St
Apt 313
Ketchikan, AK 99901
Phone (907) 220-9982

1225 Tongass Ave
Ketchikan, AK 99901
Phone (907) 220-9982

3521 Lomita Blvd
Ste 103
Torrance, CA 90505

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 1

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": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1205335809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1512",
            "city": "WARD COVE",
            "state": "AK",
            "postal_code": "999281512",
            "telephone_number": "907-821-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BAWDEN ST APT 313",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016544",
            "telephone_number": "907-220-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUTH-SHAW",
        "first_name": "SHAWNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "129177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

Verify at the official NPI Registry.