Individual provider Active NPI

Shawn M Van Dingenen

  • Home Health Aide
  • Spokane, WA
National Provider Identifier
1912547613
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
3209 S Dearborn LN
Spokane, WA 99223-1535
Phone
(509) 862-9563
NPI assigned
Jan 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X Primary

Addresses

Primary practice location

3209 S Dearborn LN
Spokane, WA 99223-1535

Mailing address

3011 E Columbia Ave Apt 4
Spokane, WA 99208-2342
Phone (509) 862-9563

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1912547613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 E COLUMBIA AVE APT 4",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992082342",
            "telephone_number": "509-862-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 S DEARBORN LN",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992231535",
            "telephone_number": "509-862-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DINGENEN",
        "first_name": "SHAWN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.