Individual provider Active NPI

Danna K Nugent-Shah

  • Community Health Worker
  • McMinnville, OR
National Provider Identifier
1740451475
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
1039473 Issued in OR
Practice address
2191 NW 2ND St
McMinnville, OR 97128-9108
Phone
(503) 980-3381
NPI assigned
Mar 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 1039473 OR Primary

Addresses

Primary practice location

2191 NW 2ND St
McMinnville, OR 97128-9108

Mailing address

120 Kingsgate Rd
Lake Oswego, OR 97035-1367
Phone (503) 713-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1039473ORMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince Dec 9, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC CurrentSince Dec 9, 2024 Accepting new patients

Locations

377 NW Jasper St
Dallas, OR 97338
Phone (503) 623-1777

Organizations & group practices 2

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": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1740451475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KINGSGATE RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351367",
            "telephone_number": "503-713-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 NW 2ND ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289108",
            "telephone_number": "503-980-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT-SHAH",
        "first_name": "DANNA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "1039473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.