NPIMap

Individual provider Active NPI

Connie Shen, MD

  • Psychiatry Physician
  • Albany, OR
National Provider Identifier
1366939712
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD207858 Issued in OR
Practice address
445 3Rd Ave SW
Albany, OR 97321-2272
Phone
(541) 967-3866
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X PG188564 OR
Psychiatry Physician 2084P0800X MD207858 OR Primary

Addresses

Primary practice location

445 3Rd Ave SW
Albany, OR 97321-2272

Mailing address

PO Box 100
Albany, OR 97321-0031

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

Other practice location 2

104 4th Ave SW
Albany, OR 97321-2804
Phone (541) 967-3866

Other practice location 3

2730 Pacific Blvd SE
Albany, OR 97321-5075
Phone (541) 967-3866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221007002259 OR Practitioner - Psychiatry 3274882790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of LinnGroup PAC ID 7911984638, 25 clinicians

Practice addresses (Care Compare)

445 3Rd Ave SW
Linn County Mental Health Services
Albany, OR 97321-0031
Phone (541) 967-3866

Hospital & facility affiliations

  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD207858ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Linn Current Accepting new patients
County of Linn CurrentSince Sep 1, 2022 Accepting new patients
County of Linn CurrentSince Sep 1, 2022 Accepting new patients
County of Linn Past Accepting new patients

Locations

2730 Pacific Blvd SE
Albany, OR 97321

104 4th Ave SW
Albany, OR 97321
Phone (541) 967-3819

445 3rd Ave SW
Albany, OR 97321
Phone (541) 924-6916

445 3rd Ave SW
#H
Albany, OR 97321

Organizations & group practices 4

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.

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1366939712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973210031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 3RD AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212272",
            "telephone_number": "541-967-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 4th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973212804",
            "country_code": "US",
            "telephone_number": "541-967-3866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2730 Pacific Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973215075",
            "country_code": "US",
            "telephone_number": "541-967-3866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "CONNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "PG188564",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD207858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.