Shaun Rebecca Edwards, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

79150 Issued in OK

Practice address

550 E Washington Blvd Ste 100
Crescent City, CA 95531-8161

Phone

(707) 465-6925

Fax

(707) 387-9808

NPI assigned

Jul 20, 2015

Last updated

Apr 2, 2025By the provider in NPPES

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 names 1

• Shaun Rebecca McCormick Former name

Medicare fee-for-service enrollment

Enrolled in OK, TX, CA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Community Health CentersGroup PAC ID 9436067485, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Coast Home Care Home health agency, Crescent City, CA, CCN 057427
• Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smccormick628512@direct.ochin.org

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.

• Open Door Community Health Centers

  dba Del Norte Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment Care Compare group NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Care

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment NPD
• Integris Ambulatory Care Corporation

  dba INTEGRIS Medical Group

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Open Door Community Health Centers

  dba Open Door Downtown

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Clinic - Broken Bow

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Care Clinic-Poteau

  • Primary Care Clinic/Center
  • Poteau, OK
  • NPI 1710953799
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Sutter Coast Hospital

  • General Acute Care Hospital
  • Crescent City, CA
  • NPI 1457367062
  Care Compare affiliation
• Sutter Coast Hospital

  dba Sutter Coast Home Care

  • Home Health Agency
  • Crescent City, CA
  • NPI 1609881499
  Care Compare affiliation
• Sutter Coast Hospital

  dba Sutter Coast Community Clinic

  • General Practice Physician
  • Crescent City, CA
  • NPI 1700960267

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1679957609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DEMOSS ST.",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "88045",
            "telephone_number": "575-542-2369",
            "fax_number": "575-542-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E WASHINGTON BLVD STE 100",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318161",
            "telephone_number": "707-465-6925",
            "fax_number": "707-387-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHAUN",
        "middle_name": "REBECCA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "79150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUN",
            "last_name": "MCCORMICK",
            "middle_name": "REBECCA",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Dunn, PA-C
• Lucie Dunn, PHARM D
• Maria Stanton Durazo, RN
• Jennifer Jo Dutton
• Kristi Ann Edgar, PT, DPT
• Nabil Elkhoury, M.D.
• Christy Eileen Emrich, PSYD
• Enderts Drug Store Inc (Medicine Shoppe)
• Larry Allen Eninger, M.D.
• Envoy of Hope Inc

• Primary Care Nurse Practitioner in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.