Active NPI
Alison Blythe Shellman, PH.D.
- Clinical Child & Adolescent Psychologist
- Houston, TX
National Provider Identifier
1033694591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 6410 Fannin St Ste 824
Houston, TX 77030-3000 - Phone
- (713) 500-7840
- NPI assigned
- Oct 1, 2018
- Sex
- Female
- Sole proprietor
- No
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 Child & Adolescent Psychologist | 103TC2200X | Primary |
Addresses
Primary practice location
6410 Fannin St Ste 824
Houston, TX 77030-3000
Mailing address
803 Mountain Dr
San Marcos, TX 78666-5066
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190122002108 | TX | Practitioner - Clinical Psychologist | 6901143403 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Interoperability endpoints
- ashellman11051@direct.uth.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1033694591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 MOUNTAIN DR",
"city": "SAN MARCOS",
"state": "TX",
"postal_code": "786665066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 FANNIN ST STE 824",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303000",
"telephone_number": "713-500-7840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLMAN",
"first_name": "ALISON",
"middle_name": "BLYTHE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.