Active NPI
Carolyn Victoria Shinn, MD
- Pediatrics Physician
- Dallas, TX
National Provider Identifier
1154498319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- J0867
- Practice address
- 8355 Walnut Hill LN
#105
Dallas, TX 75231 - Phone
- (214) 368-3659
- Fax
- (214) 739-8923
- NPI assigned
- Nov 30, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | J0867 | TX | Primary |
Addresses
Primary practice location
8355 Walnut Hill LN
#105
Dallas, TX 75231
Mailing address
8355 Walnut Hill Lane
Suite 105
Dallas, TX 75231
Phone (214) 368-3659
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J0867 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154498319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8355 WALNUT HILL LANE",
"address_2": "SUITE 105",
"city": "DALLAS",
"state": "TX",
"postal_code": "75231",
"telephone_number": "214-368-3659",
"fax_number": "214-739-8923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8355 WALNUT HILL LN",
"address_2": "#105",
"city": "DALLAS",
"state": "TX",
"postal_code": "75231",
"telephone_number": "214-368-3659",
"fax_number": "214-739-8923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINN",
"first_name": "CAROLYN",
"middle_name": "VICTORIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "J0867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.