Individual provider Active NPI

Shaun C Knox, D.O., PHARM.D.

  • Internal Medicine Physician
  • Richland, WA
National Provider Identifier
1932237286
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP61005122 Issued in WA
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 942-2648
Fax
(509) 942-2812
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00060832 WA
Internal Medicine Physician 207R00000X PG168371 OR
Sports Medicine (Internal Medicine) Physician 207RS0010X 2017-01367 NC
Internal Medicine Physician 207R00000X OP61005122 WA Primary

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

2800 N Vancouver Ave
suite 230
Portland, OR 97227-1630
Phone (503) 413-4340

Other practice location 2

129 T.T. Lanier
Lillington, NC 27546-1630
Phone (910) 893-1562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20190819000551 NC Practitioner - Internal MedicinePractitioner - Sports Medicine 8325243397
I20200311002615 WA Practitioner - Internal Medicine 8325243397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH00060832WAMDPharmacist
PG168371ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center Internal Medicine Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Kadlec Regional Medical Center CurrentSince Apr 13, 2020 Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

Organizations & group practices 3

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 1

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1932237286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-942-2648",
            "fax_number": "509-942-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 N Vancouver Ave",
            "address_2": "suite 230",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271630",
            "country_code": "US",
            "telephone_number": "503-413-4340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "129 T.T. Lanier",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275461630",
            "country_code": "US",
            "telephone_number": "910-893-1562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOX",
        "first_name": "SHAUN",
        "middle_name": "C",
        "credential": "D.O., PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00060832",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG168371",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NC",
            "license": "2017-01367",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61005122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.