Individual provider Active NPI

Robin Shaughnessy, MD

  • Pediatric Cardiology Physician
  • Portland, OR
National Provider Identifier
1689689184
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
G18468 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
CDRC-P
Portland, OR 97239-3011
Phone
(503) 418-5750
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X G18468 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
CDRC-P
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
CDRC-P
Portland, OR 97239-3011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G18468ORMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Hospital District CurrentSince Dec 10, 2020 Accepting new patients
Asante CurrentSince Sep 12, 2012 Accepting new patients
Asante Three Rivers Medical Center, LLC CurrentSince Sep 2, 2012 Accepting new patients
Bay Area Hospital District CurrentSince Dec 10, 2020 Accepting new patients
Asante CurrentSince Sep 12, 2012 Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1689689184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CDRC-P",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CDRC-P",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "ROBIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OR",
            "license": "G18468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.