Shawn Patrick Padgett, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

927 Issued in KS

Practice address

801 E Douglas Ave # 2
Wichita, KS 67202-3548

Phone

(316) 315-5856

Fax

(316) 315-5701

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sedgwick

  • Public Health or Welfare Agency
  • Wichita, KS
  • NPI 1629281373
  Medicare reassignment NPD
• Family Counseling and Psychological Services, LLC

  • Family Psychologist
  • Wichita, KS
  • NPI 1619331519
  NPD Authorized official
• County of Sedgwick

  • Addiction (Substance Use Disorder) Counselor
  • Wichita, KS
  • NPI 1376624775
  NPD
• County of Sedgwick

  • Community/Behavioral Health Agency
  • Wichita, KS
  • NPI 1982351706
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1275684433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E DOUGLAS AVE # 2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023548",
            "telephone_number": "316-315-5856",
            "fax_number": "316-315-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DOUGLAS AVE # 2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023548",
            "telephone_number": "316-315-5856",
            "fax_number": "316-315-5701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 N Webb Rd",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672063413",
            "country_code": "US",
            "telephone_number": "316-636-2888",
            "fax_number": "316-636-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADGETT",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "LCP-927",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200429840D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Pace, LCPC
• Brenden Richard Pacella, DO
• Tyler W Pacholski, LMFT
• Rebecca L Paden, SLP
• Erin Padfield
• Breeze Padilla
• Raven Star Padilla
• Sonya Elisa Padilla, PH.D. #03172
• Carlee Padron
• Angela Maria Paez Rodriguez, DO

• Clinical Psychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.

Verify at the official NPI Registry.