Individual provider Active NPI

Erin R Shawn, ANP

  • Adult Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1518099241
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
20065011NP Issued in OR
Practice address
12710 SE Division St
Portland, OR 97236-3134
Phone
(503) 988-3601
Fax
(503) 988-3142
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 20065011NP OR Primary

Addresses

Primary practice location

12710 SE Division St
Portland, OR 97236-3134

Mailing address

421 SW Oak St
210
Portland, OR 97204-1817
Phone (503) 988-3663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eshawn521164@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20070917000159 OR Practitioner - Nurse Practitioner 9436243847 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20065011NPORMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jun 12, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Nov 11, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 15, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 12, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 15, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 11, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 15, 2015 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 15, 2015 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

7305 SE Circuit Dr
Ste 260
Hillsboro, OR 97129
Phone (503) 342-9928

1510 Division St
Ste 80
Oregon City, OR 97045
Phone (503) 655-0775

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

9155 SW Barnes Rd
Ste 730
Portland, OR 97225
Phone (503) 216-4033

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

5050 NE Hoyt St
Ste 255
Portland, OR 97213
Phone (503) 215-6085

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

4805 NE Glisan St
Ste 3E14
Portland, OR 97213

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

Organizations & group practices 12

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1518099241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "address_2": "210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-3663",
            "fax_number": "503-988-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363134",
            "telephone_number": "503-988-3601",
            "fax_number": "503-988-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWN",
        "first_name": "ERIN",
        "middle_name": "R",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "20065011NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eshawn521164@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 255",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.