SHANNON GAINES — NPI 1780414060 (Licensed & Credentialed Registered Nurse, Wound Care in SALEM, WI)

CMS-1500 Box 24J / 33a • NPI

1780414060

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163WW0000X

Licensed & Credentialed Registered Nurse, Wound Care

Box 32 Service Location & ZIP+4

23323 87TH ST, SALEM, WI, 53168-9437

✓ 9-Digit EDI 837 ZIP+4 (53168-9437)

Practice Phone & Referral Fax

(262) 977-0070

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1780414060 (SHANNON GAINES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1780414060` (NPI-1 Individual Practitioner)
Provider / Legal Name	SHANNON GAINES
Plain-English Specialty	Licensed & Credentialed Registered Nurse, Wound Care NUCC Code: `163WW0000X` (Registered Nurse, Wound Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	23323 87TH ST, SALEM, WI, 53168-9437
Practice Telephone / Fax	Tel: (262) 977-0070
Administrative Mailing Address	23323 87TH ST, SALEM, WI, 53168-9437
Enumeration & Last Sync	Enumerated: 2024-08-02 \| CMS Record Updated: 2024-08-02

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

23323 87TH ST, SALEM, WI, 53168-9437

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Plain-English Taxonomy & CMS Crosswalk (163WW0000X)

What Does Taxonomy Code 163WW0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WW0000X translates to:
"Licensed & Credentialed Registered Nurse, Wound Care"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Registered Nurse, Wound Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SHANNON GAINES)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163WW0000X` — Registered Nurse, Wound Care Plain English: Licensed & Credentialed Registered Nurse, Wound Care	State: IL \| License: `041.527344` \| Primary: Secondary
`163WW0000X` — Registered Nurse, Wound Care Plain English: Licensed & Credentialed Registered Nurse, Wound Care	State: WI \| License: `234239-30` \| Primary: Yes (Primary)

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SHANNON GAINES (NPI #1780414060)