Individual provider Active NPI

Shannon Prescott, MSN, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1275169591
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61163372 Issued in WA
Practice address
4526 Federal Ave
Everett, WA 98203-2132
Phone
(425) 349-6200
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 458700 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP.0027166 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61163372 WA Primary

Addresses

Primary practice location

4526 Federal Ave
Everett, WA 98203-2132

Mailing address

4526 Federal Ave
Everett, WA 98203-2132
Phone (425) 349-6200

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.0027166OtherOHLICENSE

Other names 1

  • Shannon Prescott Professional name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324001734 WA Practitioner - Nurse Practitioner 4082020656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
458700OHMDPsychiatric/Mental Health Registered Nurse
CNP.0027166OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health CurrentSince Nov 26, 2021 Accepting new patients

Locations

4526 Federal Ave
Everett, WA 98203
Phone (425) 349-8397

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": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1275169591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        },
        {
            "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": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "SHANNON",
        "credential": "MSN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "458700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "CNP.0027166",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61163372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "APRN.CNP.0027166",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "PRESCOTT",
            "credential": "CNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.