Active NPI
Suzanne H Shelton, PHD
- Clinical Psychologist
- Redmond, WA
National Provider Identifier
1285731000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1818
- Practice address
- 15446 Bel Red Rd
Ste 430
Redmond, WA 98052 - Phone
- (425) 881-6611
- Fax
- (425) 657-0748
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1818 | WA | Primary |
Addresses
Primary practice location
15446 Bel Red Rd
Ste 430
Redmond, WA 98052
Mailing address
15446 Bel Red Rd
Ste 430
Redmond, WA 98052
Phone (425) 881-6611
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00197948 | Medicaid | WA | |
| SH0285 | Other | WA | REGENCE RIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040225000959 | WA | Practitioner - Clinical Psychologist | 6800782921 | Practice locations: Sammamish, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
Sammamish, WA 98029
Phone (425) 881-6611
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1818 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285731000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15446 BEL RED RD",
"address_2": "STE 430",
"city": "REDMOND",
"state": "WA",
"postal_code": "98052",
"telephone_number": "425-881-6611",
"fax_number": "425-657-0748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15446 BEL RED RD",
"address_2": "STE 430",
"city": "REDMOND",
"state": "WA",
"postal_code": "98052",
"telephone_number": "425-881-6611",
"fax_number": "425-657-0748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "SUZANNE",
"middle_name": "H",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PSY1818",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00197948",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE RIDER",
"identifier": "SH0285",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.