Individual provider Active NPI

Carriann Marie Shae, MD

  • Obstetrics & Gynecology Physician
  • Spokane, WA
National Provider Identifier
1962908996
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD61309804 Issued in WA
Practice address
105 W 8TH Ave Ste 6020
Spokane, WA 99204-2328
Phone
(509) 455-5050
Fax
(509) 624-5034
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X MD61309804 WA Primary

Addresses

Primary practice location

105 W 8TH Ave Ste 6020
Spokane, WA 99204-2328

Mailing address

105 W 8TH Ave Ste 6020
Spokane, WA 99204-2328
Phone (509) 455-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230202001664 WA Practitioner - Obstetrics/Gynecology 4789056623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Washington School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Obstetrics and Gynecology PLLCGroup PAC ID 4981145364, 5 clinicians

Practice addresses (Care Compare)

105 W 8TH Ave
Suite 6020
Spokane, WA 99204-2319
Phone 5094555050126

Hospital & facility affiliations

  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61309804WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Wa Past Accepting new patients

Organizations & group practices 2

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": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1962908996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 6020",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042328",
            "telephone_number": "509-455-5050",
            "fax_number": "509-624-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 6020",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042328",
            "telephone_number": "509-455-5050",
            "fax_number": "509-624-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAE",
        "first_name": "CARRIANN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD61309804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.