Individual provider Active NPI

Shannon Rose Tesky, APRN NP

  • Family Medicine Physician
  • Molalla, OR
National Provider Identifier
1205661675
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10030182 Issued in OR
Practice address
PO Box 348
Molalla, OR 97038-0348
Phone
(503) 756-7885
NPI assigned
Sep 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10030182 OR
Family Medicine Physician 207Q00000X 10030182 OR Primary

Addresses

Primary practice location

PO Box 348
Molalla, OR 97038-0348

Mailing address

PO Box 348
Molalla, OR 97038-0348
Phone (503) 756-7885

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002924 OR Practitioner - Nurse Practitioner 3274032560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silverton HealthGroup PAC ID 8921901877, 147 clinicians

Practice addresses (Care Compare)

861 W Main St
Molalla, OR 97038-9352
Phone (503) 874-5670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10030182ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health Family Medicine CurrentSince Jul 30, 2025 Accepting new patients
Silverton Health Current Accepting new patients
Silverton Health CurrentSince Jul 30, 2025 Accepting new patients
Silverton Health Family Medicine Past Accepting new patients

Locations

861 W Main St
Molalla, OR 97038
Phone (503) 829-7344

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

335 Fairview St
Silverton, OR 97381
Phone (503) 873-4115

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

1475 Mount Hood Ave
Ste 110
Woodburn, OR 97071
Phone (971) 983-5360

Interoperability endpoints

  • Direct secure messaging: stesky1596342@direct.lhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1205661675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 348",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970380348",
            "telephone_number": "503-756-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 348",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970380348",
            "telephone_number": "503-756-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESKY",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "credential": "APRN NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10030182",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "10030182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Molalla, OR

Sources for this page

Verify at the official NPI Registry.