Individual provider Active NPI

Shauna A Spellman, ARNP

  • Family Medicine Physician
  • Post Falls, ID
National Provider Identifier
1346248507
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NP428A Issued in ID
Practice address
1220 E Polston Ave
Post Falls, ID 83854
Phone
(208) 273-1577
Fax
(208) 773-8585
NPI assigned
Jul 12, 2005
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP428A ID
Family Medicine Physician 207Q00000X NP428A ID Primary

Addresses

Primary practice location

1220 E Polston Ave
Post Falls, ID 83854

Mailing address

1220 E Polston Ave
Post Falls, ID 83854
Phone (208) 273-1577

Other identifiers 1

IdentifierTypeStateIssuer
805528300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20100903000405 ID Practitioner - Nurse Practitioner 0042334658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Falls Family Medicine P.a.Group PAC ID 5991780488, 7 clinicians

Practice addresses (Care Compare)

1220 E Polston Ave
Post Falls, ID 83854-6056
Phone (208) 773-1577

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP428AIDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Post Falls Family Medicine P.a. Family Medicine CurrentSince Sep 3, 1999 Accepting new patients

Locations

1220 E Polston Ave
Post Falls, ID 83854
Phone (208) 773-1577

Interoperability endpoints

  • Direct secure messaging: shauna.spellmanarnp.p3@direct.kootenai.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1346248507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-273-1577",
            "fax_number": "208-773-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-273-1577",
            "fax_number": "208-773-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "SHAUNA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP428A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "NP428A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805528300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.