Active NPI
Pamela L Shuman, MD
- Child & Adolescent Psychiatry Physician
- Danielson, CT
National Provider Identifier
1265409031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 047955
- Practice address
- 934 N Main St
Danielson, CT 06239-1405 - Phone
- (860) 779-2101
- Fax
- (860) 779-3807
- NPI assigned
- Mar 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 047955 | CT | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 9144 | RI |
Addresses
Primary practice location
934 N Main St
Danielson, CT 06239-1405
Mailing address
189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7005695 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9144 | RI | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windham Community Memorial Hospital, Inc. | Current | Accepting new patients | |
| Natchaug Hospital, Inc. | Current | Accepting new patients |
Locations
934 N Main St
Danielson, CT 06239
Phone (860) 779-2101
189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311
112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410
Interoperability endpoints
- pamela.shuman@xdr.hhchealthdirect.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Mansfield Center, CT
- NPI 1295811321
-
- General Acute Care Hospital
- Willimantic, CT
- NPI 1023191467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1265409031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "189 STORRS RD",
"city": "MANSFIELD CENTER",
"state": "CT",
"postal_code": "062501683",
"telephone_number": "860-456-1311",
"fax_number": "860-423-6114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 N MAIN ST",
"city": "DANIELSON",
"state": "CT",
"postal_code": "062391405",
"telephone_number": "860-779-2101",
"fax_number": "860-779-3807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMAN",
"first_name": "PAMELA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CT",
"license": "047955",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "RI",
"license": "9144",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7005695",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Danielson, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.