Shanna Pugh, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA165436 Issued in OR

Practice address

1701 NW Hawthorne Ave
Grants Pass, OR 97526-1051

Phone

(541) 471-3455

Fax

(541) 471-1439

NPI assigned

Nov 7, 2013

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siskiyou Community Health Center IncGroup PAC ID 6305747288, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanna.pugh@direct.siskiyou.nextgenshare.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.

• Siskiyou Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
  • NPI 1427046903
  Medicare reassignment Care Compare group NPD
• Siskiyou Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Grants Pass, OR
  • NPI 1679053946
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1326477589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261051",
            "telephone_number": "541-471-3455",
            "fax_number": "541-471-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261051",
            "telephone_number": "541-471-3455",
            "fax_number": "541-471-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "SHANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA165436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zackeria RL Privett, PSS
• Pro Physical Therapy LLC
• David N Procknow, MD
• Providence Health & Services - Oregon
• Debra Pruyn, LCSW, QMHP
• Russ Pulliam
• Lance Christopher Pursley, LAC, MAOM
• Regina Purtzer
• Merri Sjaan Pylkas, PT
• Todd M Pylkas, PT

• Medical Physician Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.