Carolyn Jean Shoemaker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60620540 Issued in WA

Practice address

1433 5TH St
Clarkston, WA 99403-2714

Phone

(509) 758-5141

Fax

(509) 758-5299

NPI assigned

Dec 10, 2010

Last updated

Jul 31, 2026By 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 ID, WA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Clarkston PLLCGroup PAC ID 5597102335, 6 clinicians

Gritman Medical Center IncGroup PAC ID 4981984390, 19 clinicians

Gritman Medical Center IncGroup PAC ID 0941545784, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gritman Medical Center Hospital, Moscow, ID, CCN 131327
• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Gritman Medical Center, Inc.

  dba Moscow Family Medicine

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522
  Medicare reassignment Care Compare group NPD
• Gritman Medical Center Inc

  dba Troy Clinic

  • Rural Health Clinic/Center
  • Troy, ID
  • NPI 1477004828
  Medicare reassignment Care Compare group NPD (past)
• Integrated Dermatology of Clarkston PLLC

  • Dermatology Physician
  • Clarkston, WA
  • NPI 1609656222
  Medicare reassignment Care Compare group
• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Medicare reassignment NPD
• Walter Leroy Williams, M.D.

  • Dermatology Physician
  • Clarkston, WA
  • NPI 1841269248
  Medicare reassignment
• Gritman Medical Center Inc

  dba Gritman Neurosurgery

  • Neurological Surgery Physician
  • Moscow, ID
  • NPI 1487428447
  NPD
• Gritman Medical Center Inc

  dba Gritman Orthopedic Surgeons

  • Orthopaedic Surgery Physician
  • Moscow, ID
  • NPI 1811576838
  NPD
• Gritman Medical Center Inc

  dba Gritman Internal Medicine Clinic

  • Internal Medicine Physician
  • Moscow, ID
  • NPI 1235680703
  NPD (past)

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

• Public Hospital District #1-a of Whitman County

  dba Pullman Regional Hospital

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation
• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Care Compare affiliation
• Gritman Medical Center Inc.

  dba Gritman Internal Medicine Clinic

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1477856649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 5TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032714",
            "telephone_number": "509-758-5141",
            "fax_number": "509-758-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 S. Main St.",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "ID",
            "postal_code": "83871",
            "country_code": "US",
            "telephone_number": "208-835-5550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 S Main St",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838433041",
            "country_code": "US",
            "telephone_number": "208-883-1152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "CAROLYN",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-879",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60620540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seker R Medavarapu (Clearwater Braces)
• Leah Severson, RDN, CSR, LD, CD
• Munir Wesley Shah, MA
• Kody Lee Sheets, LDO
• Scott Oliver Shelden, DC
• Chase Patrick Simpson, CRNA
• Dorothea Skalicky, BS, CDP
• Michelle Lynn Skinner, RD CD
• Mickey Dean Smith, RDH
• Snake River Adult Medicine LLC

• Physician Assistant in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.