Shannon D Tumblin, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61073447 Issued in WA

Practice address

30 NW Birch St
Coupeville, WA 98239-3103

Phone

(360) 678-1515

Fax

(360) 678-5037

NPI assigned

May 19, 2020

Last updated

Dec 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stumblin@ifaderm.emadirect.md

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.

• Island Facial Aesthetics P.S.

  • Nurse Practitioner
  • Coupeville, WA
  • NPI 1164054961
  Medicare reassignment NPD

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

• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Oak Harbor, WA
  • NPI 1144348228
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
  • NPI 1164549549
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
  • NPI 1497640445
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
  • NPI 1710927231
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Coupeville, WA
  • NPI 1902771728
  Care Compare affiliation
• Whidbey Island Public Hospital District

  • Critical Access Hospital
  • Clinton, WA
  • NPI 1992823595
  Care Compare affiliation

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1376166884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JACOBS RD",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982399552",
            "telephone_number": "360-914-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NW BIRCH ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393103",
            "telephone_number": "360-678-1515",
            "fax_number": "360-678-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMBLIN",
        "first_name": "SHANNON",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61073447",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61073447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Drew Thompson, M.D.
• Zane Alan Thompson, M.D.
• Sierra K Tibbetts, AU.D.
• Diane Marie Trepanier, ARNP
• Kristen Tully, B.S. SOCIAL SERVICES
• Thomas B Vader, MD
• Ana Maria Govorcin Valencia, BCBA
• Joycelin Elaine Vester
• Tyrone Arvell Vester
• Wylie Nicholas Vracin, MD

• Family Nurse Practitioner in Coupeville, WA
• Providers in Coupeville, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.