Individual provider Active NPI

Marsha Shennum Burns, NP

  • Gerontology Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1730323528
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
60399098-NP Issued in WA
Practice address
2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2309
Phone
(360) 487-2727
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 194415 MA
Gerontology Nurse Practitioner 363LG0600X 050478-23 NH
Gerontology Nurse Practitioner 363LG0600X 60399098-NP WA Primary
Gerontology Nurse Practitioner 363LG0600X 201401568NP-PP OR

Addresses

Primary practice location

2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2309

Mailing address

2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2309
Phone (360) 487-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130927000504 WA Practitioner - Nurse Practitioner 3476690983 Reassigns benefits to 1 organization
I20140716000812 OR Practitioner - Nurse Practitioner 3476690983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
194415MAMDGerontology Nurse Practitioner
050478-23NHMDGerontology Nurse Practitioner
201401568NP-PPORMDGerontology Nurse Practitioner
60399098-NPWAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Sep 16, 2013 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 16, 2013 Accepting new patients
Legacy Clinics LLC CurrentSince Apr 27, 2014 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2222 NW Lovejoy St
Ste 315
Portland, OR 97210
Phone (503) 226-6321

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727

Interoperability endpoints

  • Direct secure messaging: mburns91854@direct.lhs.org

Organizations & group practices 4

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1730323528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST",
            "address_2": "SUITE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862309",
            "telephone_number": "360-487-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST",
            "address_2": "SUITE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862309",
            "telephone_number": "360-487-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "MARSHA",
        "middle_name": "SHENNUM",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "194415",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NH",
            "license": "050478-23",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "60399098-NP",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201401568NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.