Shawn M McKissick, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP1949 Issued in AZ

Practice address

1735 E Skyline Dr
Tucson, AZ 85718-1162

Phone

(520) 618-1630

Fax

(520) 618-1636

NPI assigned

Jan 4, 2006

Last updated

Oct 21, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: smckissick@ironwooddermatology.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carondelet Health Network

  dba Bridges Geropsychiatric Program at St. Mary's Hospital

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1750788667
  NPD (past)
• Pima Heart Physicians, PC

  dba Pima Heart & Vascular

  • Cardiovascular Disease Physician
  • Sierra Vista, AZ
  • NPI 1003081803
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1942288642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 N CAMPBELL AVE STE 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191563",
            "telephone_number": "520-320-3918",
            "fax_number": "520-692-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 E SKYLINE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-618-1630",
            "fax_number": "520-618-1636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 N La Canada Dr",
            "address_purpose": "LOCATION",
            "city": "Green Valley",
            "state": "AZ",
            "postal_code": "856143141",
            "country_code": "US",
            "telephone_number": "520-230-4540",
            "fax_number": "520-300-7117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1238 W Orange Grove Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857042950",
            "country_code": "US",
            "telephone_number": "520-838-3540",
            "fax_number": "520-325-3526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "SHAWN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "RN083510",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP1949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874760",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley McKinney, LMSW
• Chad Edward McKinney, OD
• Maya McKinney
• Rebecca Jean McKinney, AU.D.
• Samantha McKinnon
• Colleen McKisson, R.D.
• Matthew McKowen
• Mallow Fay McKusick, PT
• McLain Enterprises, Inc (Comfort Keepers)
• Michelle Lynn McLain, PHARM. D.

• Acute Care Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.