Individual provider Active NPI

Scarlet Madison Shoudy, ARNP, PNPAC

  • Pediatric Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1417638859
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
61632511 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(206) 987-2000
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 61632511 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

15008 40TH Ave W Unit B1
Lynnwood, WA 98087-6499
Phone (360) 320-4964

Other names 1

  • Scarlet Madison Inches Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250429002178 WA Practitioner - Nurse Practitioner 7618493024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61632511WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital CurrentSince Apr 18, 2025 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Seattle Childrens Hospital CurrentSince Apr 18, 2025 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

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.

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1417638859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15008 40TH AVE W UNIT B1",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980876499",
            "telephone_number": "360-320-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUDY",
        "first_name": "SCARLET",
        "middle_name": "MADISON",
        "credential": "ARNP, PNPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "61632511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SCARLET",
            "last_name": "INCHES",
            "middle_name": "MADISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.