Individual provider Active NPI

Shannon Harper

  • Clinical Psychologist
  • Albany, NY
National Provider Identifier
1114454550
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
023459 Issued in NY
Practice address
2 Clara Barton Dr
Albany, NY 12208-3472
Phone
(182) 625-5511
Fax
(518) 262-6111
NPI assigned
May 16, 2017
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 023459 NY Primary

Addresses

Primary practice location

2 Clara Barton Dr
Albany, NY 12208-3472

Mailing address

2 Clara Barton Dr
Albany, NY 12208-3472
Phone (182) 625-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226000778 NY Practitioner - Clinical Psychologist 1658705769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
023459NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Oct 27, 2019 Accepting new patients
Albany Medical College CurrentSince Oct 27, 2019 Accepting new patients
Albany Medical College CurrentSince Oct 27, 2019 Accepting new patients

Locations

1365 Washington Ave
Ste 300
Albany, NY 12206
Phone (518) 489-4704

2 Clara Barton Dr
Albany, NY 12208
Phone (518) 262-5511

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1114454550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CLARA BARTON DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083472",
            "telephone_number": "182-625-5511",
            "fax_number": "518-262-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CLARA BARTON DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083472",
            "telephone_number": "182-625-5511",
            "fax_number": "518-262-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.