Individual provider Active NPI

Shaun Hamlett Keel, EDD

  • Psychologist
  • Lubbock, TX
National Provider Identifier
1285099200
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
23761 Issued in TX
Practice address
2402 52ND St
Suite 7
Lubbock, TX 79412-2500
Phone
(806) 792-3181
Fax
(806) 792-3182
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 23761 TX Primary

Addresses

Primary practice location

2402 52ND St
Suite 7
Lubbock, TX 79412-2500

Mailing address

2402 52ND St
Suite 7
Lubbock, TX 79412-2500
Phone (806) 792-3181

Other identifiers 1

IdentifierTypeStateIssuer
033541601MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
23761TXMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1285099200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 52ND ST",
            "address_2": "SUITE 7",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122500",
            "telephone_number": "806-792-3181",
            "fax_number": "806-792-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 52ND ST",
            "address_2": "SUITE 7",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122500",
            "telephone_number": "806-792-3181",
            "fax_number": "806-792-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEL",
        "first_name": "SHAUN",
        "middle_name": "HAMLETT",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033541601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.