Shannon L. Servin-Obert, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO176333 Issued in OR

Practice address

834 Sheridan St
Port Townsend, WA 98368-2443

Phone

(360) 385-2200

Fax

(360) 344-1019

NPI assigned

Jun 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sservinobert163507@samhealth.direct-ci.com

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.

• Jefferson County Public Hospital District No 2

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Medicare reassignment NPD
• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment NPD
• Olney Emergency Group, a Professional LLC

  • Emergency Medicine Physician
  • Toppenish, WA
  • NPI 1386108868
  Medicare reassignment NPD
• Pacific County Hospital District 2

  • Critical Access Hospital
  • South Bend, WA
  • NPI 1295708683
  Medicare reassignment NPD
• Sunnyside Emergency Group a Professional LLC

  • Emergency Medicine Physician
  • Sunnyside, WA
  • NPI 1033529367
  Medicare reassignment NPD
• Washington Emergency Physician Partners PLLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1346586351
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Roseburg, OR
  • NPI 1780647719
  Medicare reassignment NPD
• Jefferson County Public Hospital District No 2

  • Urology Physician
  • Port Townsend, WA
  • NPI 1174917033
  NPD
• Kittitas County Public Hosp Dist 1

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Cle Elum, WA
  • NPI 1194747774
  NPD
• Pacific County Hospital District 2

  • Rural Health Clinic/Center
  • South Bend, WA
  • NPI 1760582522

  Family Medicine

  NPD
• Washington Emergency Physician Partners, PLLC

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1598162844
  NPD

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1285861989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200",
            "fax_number": "360-344-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200",
            "fax_number": "360-344-1019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Founders Way",
            "address_purpose": "LOCATION",
            "city": "Forks",
            "state": "WA",
            "postal_code": "983319062",
            "country_code": "US",
            "telephone_number": "360-374-6998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 N Santiam Hwy",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973554363",
            "country_code": "US",
            "telephone_number": "541-258-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERVIN-OBERT",
        "first_name": "SHANNON",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60188240",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO176333",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO176333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sservinobert163507@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "525 N Santiam Hwy",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Loran Scruggs, LAC
• Marianne Heather Sears, LMP
• Catherine Ashley Seiffert, LMP
• Suzanne C. Selisch, PRH
• Selena Sena-Hopkins, MA, LMHC
• Jamie Seton
• Edward A Shapiro, M.D.
• Steven Shapiro
• Marrisa L Shaw
• Teresa Ann Shelley, RN

• Emergency Medicine Physician in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.