Pamela Jeane Shrader, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

120179 Issued in WV

Practice address

150 Misty LN
Princeton, WV 24740-6462

Phone

(304) 425-4040

NPI assigned

Jun 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Princeton Family Medicine, PLLC

  • Family Medicine Physician
  • Princeton, WV
  • NPI 1154435881
  Medicare reassignment NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1932942646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 CARL J DR",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247017347",
            "telephone_number": "304-809-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MISTY LN",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247406462",
            "telephone_number": "304-425-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRADER",
        "first_name": "PAMELA",
        "middle_name": "JEANE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "120179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Shirey, RPH
• Richard A Shorter, DO
• Amanda Elizabeth Showalter
• Derrick Jerome Showalter
• Colleen Nicole Shrader, MSW
• Maria Shrewsberry, LPN
• Sonya E. Shrewsberry
• Amanda Beth Shrewsbury
• Amanda Lee Shrewsbury
• Brittany Hope Shrewsbury, PA-C

• Family Medicine Physician in Princeton, WV
• Providers in Princeton, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.