Active NPI
Joshua Shanahan
- Psychiatry Physician
- Erie, PA
National Provider Identifier
1275374308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OT023657
- Practice address
- 5515 Peach St
Erie, PA 16509-2603 - Phone
- (814) 868-2476
- NPI assigned
- Jun 3, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OT023657 | PA | Primary |
Addresses
Primary practice location
5515 Peach St
Erie, PA 16509-2603
Mailing address
5515 Peach St
Erie, PA 16509-2603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716000247 | PA | Order and Referring Only - Psychiatry | 1850836701 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1275374308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5515 PEACH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165092603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5515 PEACH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165092603",
"telephone_number": "814-868-2476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANAHAN",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-03",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OT023657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.