Active NPI
Shawnna Brown
- School Psychologist
- Belvidere, IL
National Provider Identifier
1063928398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2384582
- Practice address
- 9393 Beloit Rd
Belvidere, IL 61008-9735 - Phone
- (815) 547-3843
- NPI assigned
- Dec 22, 2017
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2384582 | IL | Primary |
Addresses
Primary practice location
9393 Beloit Rd
Belvidere, IL 61008-9735
Mailing address
919 Jordan PL
Rockford, IL 61108-3705
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811165061 | Medicaid | IL |
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 |
|---|---|---|---|
| 2384582 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1063928398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 JORDAN PL",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611083705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9393 BELOIT RD",
"city": "BELVIDERE",
"state": "IL",
"postal_code": "610089735",
"telephone_number": "815-547-3843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHAWNNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-22",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "2384582",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811165061",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belvidere, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.