Shannon B Radke, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00036530 Issued in WA

Practice address

714 W Pine St
Newport, WA 99156-9046

Phone

(509) 447-2441

Fax

(509) 447-0456

NPI assigned

Sep 28, 2006

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

Other identifiers 2

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pend Oreille County Public Hospital District No 1Group PAC ID 3274431184, shared by 5 NPIs, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Spokane Valley, WA, CCN 507044
• Newport Community Hospital Hospital, Newport, WA, CCN 501310
• Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pend Oreille County Public Hospital District No 1

  • Emergency Medicine Physician
  • Newport, WA
  • NPI 1427264795
  Medicare reassignment NPD
• Pend Oreille County Public Hospital District No 1

  • Critical Access Hospital
  • Newport, WA
  • NPI 1780778423
  Medicare reassignment NPD
• Pend Oreille County Public Hospital District No 1

  • Community/Retail Pharmacy
  • Newport, WA
  • NPI 1134831415
  NPD
• Pend Oreille County Public Hospital District No 1

  • Clinic/Center
  • Newport, WA
  • NPI 1720294002

  Family Medicine

  NPD
• Pend Oreille County Public Hospital District No 1

  • Rural Health Clinic/Center
  • Newport, WA
  • NPI 1912026360

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Washington Home Health, Inc.

  • Home Health Agency
  • Spokane Valley, WA
  • NPI 1336379015
  Care Compare affiliation
• Pend Oreille County Public Hospital District No 1

  • Critical Access Hospital
  • Newport, WA
  • NPI 1780778423
  Care Compare affiliation
• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Bonner General Hospital Inc.

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1992897276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-2441",
            "fax_number": "509-447-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-2441",
            "fax_number": "509-447-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "SHANNON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00036530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806529300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8345274",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Peters
• Aaron Petersen, MD
• Lynn A Peterson, MSN, CRNA
• Molly O Phillips, LICMSW
• Steven Price, PHYSICAL THERAPIST A
• Mary Jane Ramirez
• Cody March Windell Reed
• Patrick Reeves
• James Reilley
• Aaron Reinke, MD

• Family Medicine Physician in Newport, WA
• Providers in Newport, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.