NICOLE SKYE SHOCKLEY (NPI# 1538631692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538631692 |
| Entity Type | Individual |
| Full Name | NICOLE SKYE SHOCKLEY |
| Practice Address |
625 Ne Galloway St Mcminnville OR 97128-3933 |
| Mailing Address |
629 Nw Cypress St Mcminnville OR 97128-5202 |
| Practice Telephone | 5034347523 |
| Mailing Telephone | 9717166268 |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124569041 | Nicole Shockley | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807-2730 | 2017-03-10 |
| Street Address |
625 NE GALLOWAY ST |
| City | MCMINNVILLE |
| State | OR |
| Zip Code | 97128-3933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184818411 | Joel Brian Friedrich | Peer Specialist | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2007-08-29 |
| 1255804837 | Tina Good | Nurse's Aide | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2019-01-07 |
| 1821566613 | Alexander Joseph Stein | Registered Nurse | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2018-11-09 |
| 1467943373 | Kathleen Louise Orem | Peer Specialist | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2018-05-25 |
| 1649761552 | Niki L Demar | Behavior Technician | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2018-05-25 |
| 1043729940 | Caitlin Briana Schrage | Social Worker | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2017-09-22 |
| 1740633205 | Patti Carter | Community Health Worker | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2016-07-20 |
| 1275995466 | Sarah Tiffany Ramirez | Peer Specialist | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2016-03-25 |
| 1639587355 | David Libemday | Community Health Worker | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2014-07-25 |
| 1154667541 | Brianna Dietrich | Peer Specialist | 625 Ne Galloway St, Mcminnville, OR 97128-3933 | 2012-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1811502636 | Sean Peter Christian Cavaghan | Counselor | 1900 Ne Hwy 99, Suite K, Mcminnville, OR 97128 | 2020-09-09 |
| 1386269637 | Tending The Vineyard | Clinic/Center | 127 Nw Highway 99w, Mcminnville, OR 97128 | 2020-06-12 |
| 1619441094 | Kami Naber | Counselor | 672 Ne Evans St, Mcminnville, OR 97128 | 2019-01-18 |
| 1720552102 | Lauren Nicole Abshire | Counselor | 672 Ne Evans Street, Mcminnville, OR 97128 | 2019-01-18 |
| 1366933376 | Maria G Guerrero | Specialist | 325 Nw Fenton St, Mcminnville, OR 97128 | 2018-05-24 |
| 1235628819 | Julie Luedtke | Health Educator | 300 Sw Hill Road South, Mcminnville, OR 97128 | 2018-05-09 |
| 1356838817 | Jacqueline Ann Hausman | Massage Therapist | 119 Ne 3rd St., Mcminnville, OR 97128 | 2018-04-19 |
| 1366960007 | Alexis R Burke | Counselor | 625 Ne Galloway, Mcminnville, OR 97128 | 2017-09-01 |
| 1871018705 | Amanda Rose Bunch | Counselor | 418 Se Holly Way, Mcminnville, OR 97128 | 2017-08-11 |
| Find all providers in zip 97128 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692041 | Heidi Renoud | Day Training/Habilitation Specialist | 5050 Columbus St Se Unit 63, Albany, OR 97322-8017 | 2020-06-01 |
| 1033745724 | Sheryl Ann Swaisgood | Day Training/Habilitation Specialist | 754 W 4th Ave, Eugene, OR 97402-5025 | 2020-03-13 |
| 1144778432 | Linda Louise Lawson | Day Training/Habilitation Specialist | 115 10th Ave, Apt 8, Seaside, OR 97138-6237 | 2016-09-14 |
| 1437301165 | Gabriel Elihue Denison | Day Training/Habilitation Specialist | 17217 Kent Rd, Sisters, OR 97759-9301 | 2008-10-13 |
| 1790397818 | Connor O'shea | Day Training/Habilitation Specialist | 2145 Centennial Plz, Eugene, OR 97401-2421 | 2020-08-19 |
| 1578198867 | Hannah Grace Vaughan | Day Training/Habilitation Specialist | 2145 Centennial Plz, Eugene, OR 97401-2421 | 2020-03-06 |
| 1306485446 | Ian Henderson | Day Training/Habilitation Specialist | 707 Ne Couch St, Portland, OR 97232-2922 | 2020-01-06 |
| 1376186262 | Paige Mendoza | Day Training/Habilitation Specialist | 2145 Centennial Plz, Eugene, OR 97401-2421 | 2019-10-23 |
| 1962967042 | Nicole Lynn Herzog | Day Training/Habilitation Specialist | 2145 Centennial Plz, Eugene, OR 97401-2474 | 2019-02-04 |
| 1952781403 | Melanie Clark | Day Training/Habilitation Specialist | 805 Se 151st Ave, Portland, OR 97233-2916 | 2015-05-30 |
| Find all providers with the same taxonomy | ||||
| City | MCMINNVILLE |
| Zip Code | 97128 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.