Active NPI
Shannon E Scott, PH.D.
- Psychologist
- San Antonio, TX
National Provider Identifier
1275601577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 23728
- Practice address
- 11107 Wurzbach Rd
Suite 403
San Antonio, TX 78230-2500 - Phone
- (210) 697-1866
- Fax
- (210) 697-1867
- NPI assigned
- Dec 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23728 | TX | Primary |
Addresses
Primary practice location
11107 Wurzbach Rd
Suite 403
San Antonio, TX 78230-2500
Mailing address
11107 Wurzbach Rd
Suite 403
San Antonio, TX 78230-2500
Phone (210) 697-1866
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205136900 | Other | TX | TEXAS WORKER'S COMP |
| 23728 | Other | TX | STATE LICENSE |
| 00D50B | Other | TX | BLUE CROSS BLUE SHIELD |
| 032647201 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273449600000",
"number": "1275601577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11107 WURZBACH RD",
"address_2": "SUITE 403",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782302500",
"telephone_number": "210-697-1866",
"fax_number": "210-697-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11107 WURZBACH RD",
"address_2": "SUITE 403",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782302500",
"telephone_number": "210-697-1866",
"fax_number": "210-697-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "SHANNON",
"middle_name": "E",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2010-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "23728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS WORKER'S COMP",
"identifier": "205136900",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "23728",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00D50B",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "032647201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.