Individual provider Active NPI

Shawna L Laursen, MD

  • Emergency Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1528137908
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00034709 Issued in WA
Practice address
1415 E. Kincaid Street
Mount Vernon, WA 98274-4126
Phone
(360) 424-4111
NPI assigned
Nov 7, 2006
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00034709 WA Primary

Addresses

Primary practice location

1415 E. Kincaid Street
Mount Vernon, WA 98274-4126

Mailing address

1415 E. Kincaid Street
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

Other identifiers 1

IdentifierTypeStateIssuer
8208191MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000066 WA Practitioner - Emergency MedicinePractitioner - Family Practice 5597844308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00034709WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jan 8, 2013 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2017 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Dec 1, 2015 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Dec 1, 2015 Accepting new patients

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1528137908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E. KINCAID STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-424-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E. KINCAID STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-424-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "SHAWNA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00034709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8208191",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.