Individual provider Active NPI

Shirley Dempsey

  • Psychologist
  • Charleston, WV
National Provider Identifier
1285805309
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
10076 Issued in WV
Practice address
1900 Kanawha Blvd E
Charleston, WV 25305-0009
Phone
(304) 558-2696
NPI assigned
Mar 17, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 10076 WV Primary

Addresses

Primary practice location

1900 Kanawha Blvd E
Charleston, WV 25305-0009

Mailing address

1900 Kanawha Blvd E
Charleston, WV 25305-0009
Phone (304) 558-2696

Other identifiers 1

IdentifierTypeStateIssuer
0166496000MedicaidWV

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
10076WVMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
WV Department of Education Sbhse Past Accepting new patients
WV Dept of Ed Inst Ed Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1285805309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253050009",
            "telephone_number": "304-558-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253050009",
            "telephone_number": "304-558-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMPSEY",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "10076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166496000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.