Active NPI
Shanna Ratzburg, PSY.D.
- Clinical Psychologist
- Lewis Run, PA
National Provider Identifier
1043754195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3927
- Practice address
- 6975 Route 59
Lewis Run, PA 16738 - Phone
- (814) 632-8900
- NPI assigned
- Dec 8, 2016
- 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 Psychologist | 103TC0700X | 3927 | AZ | Primary |
Addresses
Primary practice location
6975 Route 59
Lewis Run, PA 16738
Mailing address
PO Box 5000
Bradford, PA 16701-0950
Phone (814) 632-8900
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3927 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481155200000",
"number": "1043754195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5000",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167010950",
"telephone_number": "814-632-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6975 ROUTE 59",
"city": "LEWIS RUN",
"state": "PA",
"postal_code": "16738",
"telephone_number": "814-632-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATZBURG",
"first_name": "SHANNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-08",
"last_updated": "2016-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewis Run, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.