Ronald Morton Shafer, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01062324A Issued in IN

Practice address

3461 Bridlewood Lane
Terre Haute, IN 47802

Phone

(812) 243-1590

Fax

(812) 234-6614

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Paras Harshawat, MD

  • Psychiatry Physician
  • Terre Haute, IN
  • NPI 1518178417
  NPD (past)
• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885
  NPD (past)
• Lifeskills, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Hopkinsville, KY
  • NPI 1346321643
  NPD (past)
• Lifeskills, Inc.

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1669401816
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1053354050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3461 BRIDLEWOOD LANE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47802",
            "telephone_number": "812-243-1590",
            "fax_number": "812-234-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 BRIDLEWOOD LANE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47802",
            "telephone_number": "812-243-1590",
            "fax_number": "812-234-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "RONALD",
        "middle_name": "MORTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01062324A",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01048560",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000481852",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200828520A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann Sekela, MS CCC-SLP
• Jarrett Selis
• Javanna Semma
• Abigail Grace Shackelford
• Emily Shafer, MA
• Dipen V Shah, M.D.
• Parita Shah
• Shailja Shah, M.D
• Michael Shamalov, HSPP
• Robin Lynn Shamsaie, PH.D.

• Psychiatry Physician in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.