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SHANNON SLACK
NPI 1790161222
Nurse Practitioner in Olympia, WA

Active since August 06, 2015PECOS Enrolled
2000 LAKERIDGE DR SW, OLYMPIA, WA 98502(360) 754-2941 Get Directions Write a Review

NPPES record last updated: April 19, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shannon Slack NPPES

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

SHANNON SLACK (NPI 1790161222) is an individual nurse practitioner in Olympia, Washington, licensed in Washington (AP60571003) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790161222
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHANNON SLACK
Location Address2000 LAKERIDGE DR SWOlympia, WA 98502-6001
Mailing Address9039 Silverspot Dr SeTumwater, WA 98501-5575 · (360) 791-7133
Phone(360) 754-2941
Sole ProprietorNo
Enumeration DateAugust 6, 2015
Last NPPES UpdateApril 19, 2017
✔ NPI 1790161222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WA · AP60571003
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2000 LAKERIDGE DR SW, Olympia, WA 98502
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Slack is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98502 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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 3

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

STACI ANN COLEMAN
Social Worker (Clinical)
2000 LAKERIDGE DR SW, BLDG 3
OLYMPIA, WA 98502
Thurston County (360) 867-2034
THURSTON COUNTY SHERIFF'S OFFICE
Family Medicine (Adult Medicine)
2000 LAKERIDGE DR SW, BLDG. 3
OLYMPIA, WA 98502
Thurston County (360) 786-5507
MICHELLE BROWNLEE PEER RECOVERY COACH
Peer Specialist
2000 LAKERIDGE DR SW
OLYMPIA, WA 98502
Thurston County (360) 701-8580

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Slack's NPI number?

The NPI number for Shannon Slack is 1790161222. It was assigned to this individual provider in the NPPES registry on August 6, 2015.

Where is Shannon Slack located?

Shannon Slack practices at 2000 Lakeridge Dr SW, Olympia, WA 98502. The listed phone number is (360) 754-2941.

What is Shannon Slack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shannon Slack enrolled in Medicare?

Yes. Shannon Slack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Slack was last updated on April 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.