Active NPI
Richard W Shallman, MD
- Surgery Physician
- Pasco, WA
National Provider Identifier
1346308483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD00024680
- Practice address
- 7425 Wrigley Dr Ste 204
Pasco, WA 99301-5292 - Phone
- (509) 547-0027
- Fax
- (509) 547-6946
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD00024680 | WA | Primary |
Addresses
Primary practice location
7425 Wrigley Dr Ste 204
Pasco, WA 99301-5292
Mailing address
520 N 4TH Ave
Pasco, WA 99301-5257
Phone (509) 416-8849
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1028083 | Medicaid | WA | |
| 020006991 | Other | WA | MEDICARE RR |
| 13040 | Other | WA | L AND I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025209 | WA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of Lourdes Hospital at Pasco | Past | Accepting new patients | |
| Our Lady of Lourdes Health Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Lourdes Riverview Medical Group
- Family Medicine Physician
- Pasco, WA
- NPI 1184708471
-
dba Lourdes Urgent Care Radiology
- Diagnostic Radiology Physician
- Pasco, WA
- NPI 1639503774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1346308483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 N 4TH AVE",
"city": "PASCO",
"state": "WA",
"postal_code": "993015257",
"telephone_number": "509-416-8849",
"fax_number": "509-542-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7425 WRIGLEY DR STE 204",
"city": "PASCO",
"state": "WA",
"postal_code": "993015292",
"telephone_number": "509-547-0027",
"fax_number": "509-547-6946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHALLMAN",
"first_name": "RICHARD",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD00024680",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1028083",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "020006991",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L AND I",
"identifier": "13040",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasco, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.