Individual provider Active NPI

Shelley Berger Dooley, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1073622940
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN-034823 Issued in AZ
Practice address
11120 N Tatum Blvd
Suite 101
Phoenix, AZ 85028-1628
Phone
(602) 443-2111
Fax
(602) 443-2110
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN-034823 AZ Primary

Addresses

Primary practice location

11120 N Tatum Blvd
Suite 101
Phoenix, AZ 85028-1628

Mailing address

11120 N Tatum Blvd
Suite 101
Phoenix, AZ 85028-1628
Phone (602) 443-2111

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-034823AZMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1073622940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 N TATUM BLVD",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281628",
            "telephone_number": "602-443-2111",
            "fax_number": "602-443-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 N TATUM BLVD",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281628",
            "telephone_number": "602-443-2111",
            "fax_number": "602-443-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLEY",
        "first_name": "SHELLEY",
        "middle_name": "BERGER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN-034823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.