Individual provider Active NPI

Dennis David Shoemaker, M.A.

  • Psychologist
  • Wernersville, PA
National Provider Identifier
1194753541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS007704L Issued in PA
Practice address
Route 422, Sportsman Road
Building 37
Wernersville, PA 19565-0300
Phone
(610) 678-3411
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS007704L PA Primary

Addresses

Primary practice location

Route 422, Sportsman Road
Building 37
Wernersville, PA 19565-0300

Mailing address

1708 Manor Ridge Dr
Lancaster, PA 17603-4446
Phone (717) 399-9468

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS007704LPAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194753541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 MANOR RIDGE DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176034446",
            "telephone_number": "717-399-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 422, SPORTSMAN ROAD",
            "address_2": "BUILDING 37",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "195650300",
            "telephone_number": "610-678-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "DENNIS",
        "middle_name": "DAVID",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS007704L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wernersville, PA

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.

Verify at the official NPI Registry.