Active NPI
Shawn Gewirtz, PH.D.
- Clinical Child & Adolescent Psychologist
- Charlottesville, VA
National Provider Identifier
1043508054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 0810004435
- Practice address
- 500 Old Lynchburg Rd
Charlottesville, VA 22903-6500 - Phone
- (434) 972-1737
- NPI assigned
- Jul 12, 2011
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810004435 | VA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 0810004435 | VA | |
| Clinical Psychologist | 103TC0700X | 0810004435 | VA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 0810004435 | VA | Primary |
| Family Psychologist | 103TF0000X | 0810004435 | VA | |
| School Psychologist | 103TS0200X | 0810004435 | VA |
Addresses
Primary practice location
500 Old Lynchburg Rd
Charlottesville, VA 22903-6500
Mailing address
1624 Shady Grove CT
Charlottesville, VA 22902-7218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942270699 | Medicaid | VA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1043508054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 SHADY GROVE CT",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229027218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 OLD LYNCHBURG RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229036500",
"telephone_number": "434-972-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWIRTZ",
"first_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-12",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810004435",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "VA",
"license": "0810004435",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004435",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "VA",
"license": "0810004435",
"primary": true
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "VA",
"license": "0810004435",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0810004435",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942270699",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.