Individual provider Active NPI

Shannon Michelle Robinson

  • Licensed Practical Nurse
  • Portland, OR
National Provider Identifier
1376085878
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
200830392LPN Issued in OR
Practice address
2600 SE Belmont St
Portland, OR 97214-2916
Phone
(503) 239-5738
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 200830392LPN OR Primary

Addresses

Primary practice location

2600 SE Belmont St
Portland, OR 97214-2916

Mailing address

1030 NE 102ND Ave Apt 25
Portland, OR 97220-3975
Phone (503) 957-4494

Other names 1

  • Shannon Michelle Green Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
200830392LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1376085878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 NE 102ND AVE APT 25",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203975",
            "telephone_number": "503-957-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142916",
            "telephone_number": "503-239-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "200830392LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "GREEN",
            "middle_name": "MICHELLE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.