Active NPI
Daniel E Shybunko, PHD,
- Clinical Psychologist
- Lexington, VA
National Provider Identifier
1023078771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810001454
- Practice address
- 108 Houston St
Suite D
Lexington, VA 24450-2455 - Phone
- (540) 464-3003
- Fax
- (540) 464-3181
- NPI assigned
- Mar 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810001454 | VA | Primary |
Addresses
Primary practice location
108 Houston St
Suite D
Lexington, VA 24450-2455
Mailing address
PO Box 1068
Lexington, VA 24450-1068
Phone (540) 464-3003
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030528 | Other | VA | VALUE OPTIONS |
| 086151 | Other | VA | SENTARA HEALTH |
| 541777975 | Other | VA | CHAMPUS |
| 260177 | Other | VA | ANTHEM BLUE CROSS OF VA |
| 007754035 | Medicaid | VA | |
| 086151 | Other | VA | SOUTHERN HEALTH SERVICES |
| 254526000 | Other | VA | MAGELLAN |
| 28051 | Other | VA | VIRGINIA PREMIER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810001454 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1023078771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1068",
"city": "LEXINGTON",
"state": "VA",
"postal_code": "244501068",
"telephone_number": "540-464-3003",
"fax_number": "540-464-3181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 HOUSTON ST",
"address_2": "SUITE D",
"city": "LEXINGTON",
"state": "VA",
"postal_code": "244502455",
"telephone_number": "540-464-3003",
"fax_number": "540-464-3181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHYBUNKO",
"first_name": "DANIEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PHD,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-26",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810001454",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "030528",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA HEALTH",
"identifier": "086151",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "541777975",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS OF VA",
"identifier": "260177",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007754035",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH SERVICES",
"identifier": "086151",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "254526000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "28051",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.