Daniel T Shiode, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0244 Issued in NV

Practice address

501 S Rancho Dr
Ste I-64
Las Vegas, NV 89106

Phone

(702) 384-4110

Fax

(702) 384-7954

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shiode Psychotherapy, Inc.

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1326178310
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1013047091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR",
            "address_2": "STE I-64",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064828",
            "telephone_number": "702-384-4110",
            "fax_number": "702-384-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR",
            "address_2": "STE I-64",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-384-4110",
            "fax_number": "702-384-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIODE",
        "first_name": "DANIEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002602062",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shining Light LLC
• Shining Minds LTD
• Shining Star Community Services
• Shining Star Community Services
• Shiode Psychotherapy, Inc.
• Deena J Shiode, LCSW
• Marisa Fumiye Shiode, M.D.
• Linda Shipman
• Shelly Shipman, RN
• Cheryl Anne Shipske, NP-C

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.