NPIMap

Individual provider Active NPI

Jared Shannon, MD

  • Family Medicine Physician
  • Hood River, OR
National Provider Identifier
1730524604
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD169579 Issued in OR
Practice address
849 Pacific Ave
Hood River, OR 97031-1956
Phone
(503) 513-8950
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OR
Family Medicine Physician 207Q00000X MD169579 OR Primary

Addresses

Primary practice location

849 Pacific Ave
Hood River, OR 97031-1956

Mailing address

PO Box 3158
Portland, OR 97208-3158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150720001895 OR Practitioner - Family Practice 8820223746 Reassigns benefits to 2 organizations
I20160915000522 WA Practitioner - Family Practice 8820223746 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

1700 E 19TH St
The Dalles, OR 97058-3317
Phone (541) 296-1111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Aug 5, 2018 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Jan 1, 2018 Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Aug 5, 2018 Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Jan 1, 2018 Accepting new patients
Mid-Columbia Medical Center CurrentSince Jan 1, 2017 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington Current Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jul 6, 2016 Accepting new patients
Mid-Columbia Medical Center Family Medicine Past Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

Interoperability endpoints

  • Direct secure messaging: jshannonmd99685@direct.ohsu.edu
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1730524604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 PACIFIC AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311956",
            "telephone_number": "503-513-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JARED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD169579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.