SHELLY BETHANN DAMSCHRODER (NP) – Family Nurse Practitioner, NPI 1164750923
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
6,268 NURSE PRACTITIONER in WA
Provider Addresses for SHELLY BETHANN DAMSCHRODER (NP)
1400 E KINCAID ST
MOUNT VERNON, WA 982744127
Phone:
Type: Mailing
901 S 5TH ST
MOUNT VERNON, WA 982743942
Phone: (360) 814-7300
Type: Location
6648 N VIEWPOINT DR STE 5
PRESCOTT VALLEY, AZ 863154942
Phone: (928) 708-4800
Fax: (928) 458-2123
Type: Location
2120 Centerpointe West Dr
Prescott, AZ 863018487
Phone: (928) 778-4581
Fax: (928) 776-1872
Type: Location
PO BOX 10880
PRESCOTT, AZ 863040880
Phone: (602) 406-4786
Fax: (916) 636-4358
Type: Mailing
3101, Clearwater Drive, Prescott, Yavapai County, Arizona, 86305, United States
SUITE B
PRESCOTT, AZ 863057180
Phone: (928) 237-9014
Fax: (928) 237-9063
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $134.
Total Amount is formed as General ($134) + Research ($0) + Ownership ($0) = $134.
Last reported payment date: 2024-02-22 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($134).
Total Amount
$134
General + Research + Ownership
Payments
2
Total payment records
General Amount
$134
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $134 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-09-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140918001777 | I | Nurse Practitioner | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98274)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Orthopedic Surgery | AZ | |
| Physician Assistant | AZ | |
| Nurse Practitioner | MI | |
| Family Practice | AZ | |
| Nurse Practitioner | SC | |
| - | TN | |
| Cardiovascular Disease (Cardiology) | AZ | |
| - | AZ | |
| Nurse Practitioner | AZ |
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