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SHANNON MACMINN
NPI 1891056057
Counselor in Portland, OR

Active since June 05, 2012PECOS Enrolled
3415 SE POWELL BLVD, PORTLAND, OR 97202(503) 234-9591 Get Directions Write a Review

NPPES record last updated: March 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Shannon Macminn NPPES

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

SHANNON MACMINN (NPI 1891056057) is an individual counselor in Portland, Oregon and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1891056057
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameSHANNON MACMINN
Location Address3415 SE POWELL BLVDPortland, OR 97202-3371
Mailing Address3415 Se Powell BlvdPortland, OR 97202-3371 · (503) 234-9591
Phone(503) 234-9591
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 5, 2012
Last NPPES UpdateMarch 13, 2026
NPPES CertifiedMarch 13, 2026
✔ NPI 1891056057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3415 SE POWELL BLVD, Portland, OR 97202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID4385112267
PECOS Enrollment IDI20260508002192
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.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Macminn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sprout Therapy Pdx LLC
7.4 mi
Counselor
7704 N HEREFORD AVE
Portland, OR 97203
  • Reassigned Medicare billing, Oregon enrollment
  • 25 clinicians in this Medicare group
NPI 1093346777 (971) 319-4827

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

AMY HETLAGE MSW
Social Worker
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
CHELSEA YOUNG
Counselor
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
HALLIE RISWOLD
Case Manager/Care Coordinator
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (541) 757-1852
MICAELA BUSACK
Case Manager/Care Coordinator
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
DANIEL TRACHUK
Counselor
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
MATTHEW PAUL SIMONSON
Counselor
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
ELSA CHRISTINA SPAULDING
Counselor
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 234-9591
PETAL GRIFFITH BS
Counselor (School)
3415 SE POWELL BLVD
PORTLAND, OR 97202
Multnomah County (503) 205-4334

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 Macminn's NPI number?

The NPI number for Shannon Macminn is 1891056057. It was assigned to this individual provider in the NPPES registry on June 5, 2012.

Where is Shannon Macminn located?

Shannon Macminn practices at 3415 SE Powell Blvd, Portland, OR 97202. The listed phone number is (503) 234-9591.

What is Shannon Macminn's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Shannon Macminn enrolled in Medicare?

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

Which organization bills Medicare for Shannon Macminn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Macminn reassigns Medicare benefits to Sprout Therapy Pdx LLC (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Macminn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shannon Macminn accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Shannon Macminn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Macminn was last updated on March 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.