NPIMap

Individual provider Active NPI

Jennifer E. Shook, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
National Provider Identifier
1851379317
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
27518 Issued in AZ
Practice address
19020 33Rd Ave W
Ste 210
Lynnwood, WA 98036-4746
Phone
(425) 563-1500
Fax
(425) 563-1374
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00036174 WA
Diagnostic Radiology Physician 2085R0202X 27518 AZ Primary

Addresses

Primary practice location

19020 33Rd Ave W
Ste 210
Lynnwood, WA 98036-4746

Mailing address

2323 W Rose Garden LN
Phoenix, AZ 85027-2530
Phone (602) 521-6252

Other identifiers 3

IdentifierTypeStateIssuer
201630OtherWAL&I PROVIDER NUMBER
8234718MedicaidWA
194628OtherWAL&I PROVIDER NUMBER

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Radiologists LTD PastSince Jan 1, 1991 Accepting new patients
East Valley Diagnostic Imaging LLC Past Accepting new patients
Everett Radia LLC Diagnostic Radiology Past Accepting new patients
Evergreen Radia LLC Diagnostic Radiology Past Accepting new patients
Desert Open MRI LLC Past Accepting new patients

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1851379317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W ROSE GARDEN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272530",
            "telephone_number": "602-521-6252",
            "fax_number": "623-842-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "JENNIFER",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00036174",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "27518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "201630",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8234718",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "194628",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.