Active NPI
Anne Balding Shankar, LCSW
- Clinical Social Worker
- Beaverton, OR
National Provider Identifier
1578743001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2193
- Practice address
- 1975 NW 167TH PL
Beaverton, OR 97006 - Phone
- (503) 531-9355
- Fax
- (503) 629-8933
- NPI assigned
- Nov 13, 2007
- Last updated
- Mar 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2193 | OR | Primary |
Addresses
Primary practice location
1975 NW 167TH PL
Beaverton, OR 97006
Mailing address
1975 NW 167TH PL
Beaverton, OR 97006-4908
Phone (503) 531-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 20, 2020 through Jul 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2193 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1578743001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 NW 167TH PL",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970064908",
"telephone_number": "503-531-9355",
"fax_number": "503-629-8933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 NW 167TH PL",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97006",
"telephone_number": "503-531-9355",
"fax_number": "503-629-8933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKAR",
"first_name": "ANNE",
"middle_name": "BALDING",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-13",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "2193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.