Individual provider Active NPI

Paula Shockley, MD

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1144313776
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD000027605 Issued in WA
Practice address
2611 NE 125TH Street
Suite 201
Seattle, WA 98125
Phone
(206) 985-8371
Fax
(206) 306-7447
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD000027605 WA Primary

Addresses

Primary practice location

2611 NE 125TH Street
Suite 201
Seattle, WA 98125

Mailing address

2611 NE 125TH Street
Suite 201
Seattle, WA 98125
Phone (206) 985-8371

Other identifiers 2

IdentifierTypeStateIssuer
1113653MedicaidWA
SH6118OtherWAREGENCE RIDER NUMBER

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD000027605WAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1144313776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 NE 125TH STREET",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-985-8371",
            "fax_number": "206-306-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 NE 125TH STREET",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-985-8371",
            "fax_number": "206-306-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "PAULA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD000027605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113653",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER NUMBER",
            "identifier": "SH6118",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.