Shanette Bruce Owen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OL60849496 Issued in WA

Practice address

6351 W Rio Grande Ave
Kennewick, WA 99336-7634

Phone

(509) 543-9280

Fax

(509) 579-5915

NPI assigned

Mar 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shanette Jean Owen Former name

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbruce25226@yvfwc.direct-ci.com

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.

• Yakima Valley Farm Workers Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Yakima, WA
  • NPI 1295788602
  Medicare reassignment Care Compare group NPD
• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1235265455
  NPD

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1629430228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367634",
            "telephone_number": "509-543-9280",
            "fax_number": "509-579-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367634",
            "telephone_number": "509-543-9280",
            "fax_number": "509-579-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE OWEN",
        "first_name": "SHANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60849496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629430228",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbruce25226@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "6351 W Rio Grande Ave",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993367634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANETTE",
            "last_name": "OWEN",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Brown, DMD
• Marc B Brown, D.C.
• Sujay Sabrinare Brown, RN
• Wendy Undeberg Brown, PT
• Ola K Browning
• Tamsen Donica Bruce, L.M.T.
• Taylor Brummett, LICSW
• Tamara Brun, RN
• Patrick (Rick) C. R. Brunk, M.ED.
• Kendall Augusta Brusseau, OT

• Family Medicine Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.