SHANNON DEE BOOTH MSN, PMHNP-BC
NPI 1083379184
Nurse Practitioner - Psychiatric/Mental Health in Wasilla, AK

Q: What is Shannon Booth's NPI number?

The NPI number for Shannon Booth is 1083379184. It was assigned to this individual provider in the NPPES registry on November 3, 2021.

Q: What is Shannon Booth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Booth was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2021PECOS EnrolledAccepts Medicare Assignment

1363 W SPRUCE AVE, WASILLA, AK 99654(907) 376-2411 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 19, 2025, Nov 7, 2022, Feb 22, 2022 and 1 more (4 updates tracked since 2021).

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About Shannon Dee Booth Msn, Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON DEE BOOTH MSN, PMHNP-BC (NPI 1083379184) is an individual psychiatric/mental health provider in Wasilla, Alaska, licensed in Alaska (182979) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, is affiliated with Kau Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1083379184

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSHANNON DEE BOOTHCredential: MSN, PMHNP-BC

Location Address1363 W SPRUCE AVEWasilla, AK 99654-5327

Mailing Address1363 W Spruce AveWasilla, AK 99654-5327 · (907) 376-2411

Phone(907) 376-2411

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateNovember 3, 2021

Last NPPES UpdateMarch 19, 20254 updates tracked since enumeration

NPPES CertifiedMarch 19, 2025

✔ NPI 1083379184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in AK · 182979✔ Licensed in HI · APRN-4445

Also ListedRegistered NurseTaxonomy 163W00000X · License 174083 (AK)

1363 W SPRUCE AVE, Wasilla, AK 99654

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Secondary Practice Locations 2

Location 13261 S Big Lake RdBig Lake, AK 99623-9663 · Phone (907) 376-2411 · Fax (907) 352-3663

Location 2425 E Dahlia Ave Ste MPalmer, AK 99645-6463 · Phone (907) 376-2411 · Fax (907) 352-3363

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Dee Booth Msn, Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345631032

PECOS Enrollment IDI20250331002161

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kau Hospital

Critical Access Hospitals · Pahala, HI

OwnershipGovernment - State

CMS Certification Number121301

Location1 Kamani StreetPahala, HI 96777 · Hawaii County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$111.57 typical visit price

range $71.33 – $222.64

Typical copayment $27.89 (range $17.83 – $55.66)

Most-billed visit code 99203

Established Patient

$128.73 typical visit price

range $21.84 – $181.48

Typical copayment $32.18 (range $5.46 – $45.37)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARIS TAYLOR LCSW-C

Counselor (Mental Health)