Shanti Colo
Individual provider Active NPI Advanced Practice Midwife · Silverton, OR
NPI 1508417577 · NPPES record last updated Feb 3, 2022
Key facts
- NPI
- 1508417577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- AP61161569 (WA)
- Practice address
- 406 Welch St
Silverton, OR 97381-1934 - Phone
- (503) 364-3787
- NPI assigned
- Sep 21, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Franciscan Medical Group
Practice addresses (Care Compare)
1608 S J St
FL 1
Tacoma, WA 98405-4930
Phone (253) 274-7501
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220214000531 | WA | Practitioner - Certified Nurse Midwife (CNM) | 2961826953 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201809217 | OR | MD | Registered Nurse |
| AP61161569 | WA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | Current |
Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Franciscan Medical Group | Current |
Accepting new patients | |
| Franciscan Medical Group | Past | Accepting new patients | |
| Franciscan Health System | Past | Accepting new patients |
Locations
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60939595 | WA | |
| Registered Nurse | 163W00000X | 201809217 | OR | |
| Advanced Practice Midwife | 367A00000X | AP61161569 | WA | Yes |
| Advanced Practice Midwife | 367A00000X | 202006152NP-PP | OR |
Addresses
Primary practice location
406 Welch St
Silverton, OR 97381-1934
Mailing address
1608 S J St
FL 1
Tacoma, WA 98405-4930
Phone (253) 274-7501
Other practice location 1
3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 913-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500781877 | Medicaid | OR |
NPI Registry JSON
{
"created_epoch": "1569024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1508417577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1608 S J ST",
"address_2": "FL 1",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054930",
"telephone_number": "253-274-7501",
"fax_number": "253-274-7991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 WELCH ST",
"city": "SILVERTON",
"state": "OR",
"postal_code": "973811934",
"telephone_number": "503-364-3787"
}
],
"practiceLocations": [
{
"address_1": "3550 N Interstate Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271196",
"country_code": "US",
"telephone_number": "800-913-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLO",
"first_name": "SHANTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-21",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60939595",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201809217",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "WA",
"license": "AP61161569",
"primary": true
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OR",
"license": "202006152NP-PP",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500781877",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverton, OR
- Robert William Chisholm
- Kendall Christensen
- Kari A. Cline
- Clinton C. Sanford MD PC
- Rachel Brigid Coleman Lesire
- Allen Fredrick Connick
- Christopher Vance Cooper
- Corey Geffken LMP
- Daniel Mario Cote
- Christine Cralen
All providers in Silverton, OR · Advanced Practice Midwife in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.