Shannon Kay Mortensen, NP is a medicare enrolled "Nurse Practitioner" in Coeur D'alene, Idaho. She graduated from nursing school in 2002 and has 22 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice North Idaho Dermatology Pa and her current practice location is
2288 Merritt Creek Loop, Coeur D'alene, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 665-7546.
Shannon Kay Mortensen is licensed to practice in Idaho (license number N-31561) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104919695.
Provider's Profile
| Full Name | Shannon Kay Mortensen |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 22 Years |
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| Location | 2288 Merritt Creek Loop, Coeur D'alene, Idaho |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shannon Kay Mortensen graduated from nursing school in 2002
NPI Data:
- NPI Number: 1104919695
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 02/05/2009
Medicare PECOS Information:
- PECOS PAC ID: 0345306163
- Enrollment ID: I20090303000636
Medical Identifiers
Medical identifiers for Shannon Kay Mortensen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104919695 | NPI | - | NPPES |
| 806523200 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | N-31561 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| North Idaho Dermatology Pa | 2365404431 | 12 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shannon Kay Mortensen allows following entities to bill medicare on her behalf.
| Entity Name | North Idaho Dermatology Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215936638
PECOS PAC ID: 2365404431
Enrollment ID: O20041101000539 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Kay Mortensen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Shannon Kay Mortensen, NP
2288 Merritt Creek Loop,
Coeur D'alene, ID 83814
Ph: (208) 665-7546 | Shannon Kay Mortensen, NP
2288 Merritt Creek Loop,
Coeur D'alene, ID 83814
Ph: (208) 665-7546 |
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