Robert Desmond Shura, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

103072 Issued in NC

Practice address

1601 Brenner Ave
11M-2
Salisbury, NC 28144-2515

Phone

(704) 638-9000

NPI assigned

Feb 23, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1174915565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "address_2": "11M-2",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "address_2": "11M-2",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURA",
        "first_name": "ROBERT",
        "middle_name": "DESMOND",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "103072",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "103072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Leann-Grace Shoffner
• Rebecca Shomo, MLA, LAT, ATC
• Shannon Gantt Shore, LCSW
• Kevin Joseph Showfety, D.D.S., M.S.
• Sacheen Shrestha, M.D.
• M Yousuf Siddiqui, M.D.
• Amie Thoburn Sides, MS SLP
• Joseph I Sie, O.D.
• Mitchell Jay Siegel, D.D.S.
• Theodore John Sikorski, MD

• Clinical Neuropsychologist in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Clinical Neuropsychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.