Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710917299 Individual Practitioner Male Practitioner

Dr. Shane B Carson , DO

Pediatrics • Spokane, WA

Professional Overview & Biography Verified Profile Summary

Dr. Shane Carson, DO is a registered healthcare professional specializing in Pediatrics in Spokane, WA. Practice services are available at 1919 S GRAND BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1919 S Grand Blvd

Spokane, WA 992032347

Telephone 5097473081
Fax 5092277070
Associated Practice Facility / Clinic
🏢 Women First, Ps Facility NPI 1346488947

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Spokane, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.8 Yrs
State Avg: 18.8 Yrs
Regional Practice Density
80 Specialists

Practicing in Spokane, WA (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-05-03
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA OP00002101

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8454654 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003374265
NPI 1003811712

Doctor of Philosophy (Ph.D.)

Dr. Robert Wales , MD, FACC

Internal Medicine - Cardiovascular Disease

NPI 1003820275

Doctor of Medicine (M.D.), FACC

Kevin Kellogg , PA-C

Physician Assistant - Surgical

NPI 1003899493

Physician Assistant (Certified)

Breanna Bergeron , RD

Dietitian, Registered

NPI 1013040849

Registered Dietitian

NPI 1013086693

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active May 18, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location May 18, 2017

Registered at 1919 S GRAND BLVD, SPOKANE, WA 992032347 (Tel: 5097473081)

📍
Updated Business Mailing Address May 18, 2017

Registered at PO BOX 421, LIBERTY LAKE, WA 990190421 (Tel: (509) 747-3081)

👤
Provider Name / Credentials Updated May 18, 2017

Recorded as SHANE CARSON, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2017

Pediatrics (License #OP00002101 in WA)

NPI Profile Active July 23, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2015

Registered at 235 E ROWAN AVE, STE 117, SPOKANE, WA 992071240 (Tel: 5097473081)

📍
Updated Business Mailing Address July 23, 2015

Registered at PO BOX 421, LIBERTY LAKE, WA 990190421 (Tel: 5097473081)

👤
Provider Name / Credentials Updated July 23, 2015

Recorded as SHANE CARSON, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2015

Pediatrics (License #OP00002101 in WA)

🟢
Initial NPI Registration & Enumeration July 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710917299
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2006
Last Update: May 03, 2021
Sole Proprietor: No

Mailing Address

Po Box 421

Liberty Lake, WA 990190421

Phone: 5097473081

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.