Individual provider Active NPI

Eric Nathanael Shute, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1023350832
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
S2379 Issued in TX
Practice address
1341 W Mockingbird LN
Dallas, TX 75247-6913
Phone
(214) 456-7700
NPI assigned
Mar 19, 2013
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X S2679 TX
Psychiatry Physician 2084P0800X S2379 TX Primary

Addresses

Primary practice location

1341 W Mockingbird LN
Dallas, TX 75247-6913

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-4319
Phone (214) 645-8898

Other identifiers 1

IdentifierTypeStateIssuer
403623801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010002112 TX Practitioner - Psychiatry 4082945787 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S2379TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Clinical Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 18, 2023 Accepting new patients
Tri-County Clinical CurrentSince Aug 13, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Psychiatry CurrentSince Dec 18, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1341 W Mockingbird Ln
Dallas, TX 75247
Phone (214) 217-7520

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1023350832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753904319",
            "telephone_number": "214-645-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476913",
            "telephone_number": "214-456-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "ERIC",
        "middle_name": "NATHANAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "S2679",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S2379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403623801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.