DR. SHANNON MARIE ETTER (M.D.) – Obstetrics & Gynecology Physician, NPI 1184829921
Obstetrics & Gynecology Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. SHANNON MARIE ETTER (M.D.)
Boone Road, Jackson Park, Jackson Park Support Area, Kitsap County, Washington, 98312, United States
NAVAL HOSPITAL BREMERTON
BREMERTON, WA 98312
Phone:
Type: Mailing
1 BOONE RD
NAVAL HOSPITAL BREMERTON
BREMERTON, WA 983121894
Phone:
Type: Mailing
9455 CLAIREMONT MESA BLVD
SAN DIEGO, CA 921231297
Phone: (858) 266-5000
Type: Location
2017 1st Ave Ste 100
San Diego, CA 921019001
Phone: (619) 881-5094
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-08-22
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 |
|---|---|---|---|---|
| I20230822002502 | I | Obstetrics/Gynecology | CA | 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 98312)
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