Shellie A Russell-Skerski, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MD198704 Issued in OR

Practice address

930 SW Abbey St Ste a
Newport, OR 97365-4820

Phone

(541) 265-8816

Fax

(541) 812-2069

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pediatric Medicine

Education

Medical College of Wisconsin, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Pacific Health Services IncGroup PAC ID 2466353529, shared by 7 NPIs, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Samaritan North Lincoln Hospital

  • Critical Access Hospital
  • Lincoln City, OR
  • NPI 1306897491
  Medicare reassignment NPD
• Samaritan Pacific Health Services, Inc

  • Critical Access Hospital
  • Newport, OR
  • NPI 1801847066
  Medicare reassignment NPD
• Samaritan Pacific Health Services, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Newport, OR
  • NPI 1174888010
  Medicare reassignment NPD
• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  Medicare reassignment NPD
• Samaritan North Lincoln Hospital

  • Surgery Physician
  • Lincoln City, OR
  • NPI 1417214388
  NPD
• Samaritan North Lincoln Hospital

  • Community/Retail Pharmacy
  • Lincoln City, OR
  • NPI 1851509905
  NPD
• Samaritan Pacific Health Services, Inc

  • Rural Health Clinic/Center
  • Depoe Bay, OR
  • NPI 1164781142
  NPD
• Samaritan Pacific Health Services, Inc.

  • Internal Medicine Physician
  • Newport, OR
  • NPI 1336574912
  NPD
• Children'S Hospital Medical Center of Akron

  • Anesthesiology Physician
  • Boardman, OH
  • NPI 1417257601
  NPD
• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1790849065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2847",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973392847",
            "telephone_number": "541-768-4410",
            "fax_number": "541-812-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST STE A",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-265-8816",
            "fax_number": "541-812-2069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 E Milltown Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "446911276",
            "country_code": "US",
            "telephone_number": "330-345-1100",
            "fax_number": "330-345-1194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL-SKERSKI",
        "first_name": "SHELLIE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-077921",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OR",
            "license": "MD198704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srussellskerski194255@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St Ste A",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heidi Renee Romney, DMD
• Robin Kenneth Ross, LCSW
• Cristina Medina Rost
• Kayti Rouch
• Vickie Lou Rounsaville, R.N.
• Jason Rutter, PA-C
• Reatha L Ryan, P.M.H.N.P. R.N.
• Stacey Ellen Saenz, RN
• Safeway Inc
• Samaritan Health Services, Inc.

• Pediatric Adolescent Medicine Physician in Newport, OR
• Providers in Newport, OR by specialty
• Pediatric Adolescent Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.