Individual provider Active NPI

Shannon Flahive, DO

  • Psychiatry Physician
  • Bozeman, MT
National Provider Identifier
1366905929
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
122486 Issued in MT
Practice address
2078 Stadium Dr Ste 101
Bozeman, MT 59715-7204
Phone
(406) 587-0810
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 122486 MT Primary

Addresses

Primary practice location

2078 Stadium Dr Ste 101
Bozeman, MT 59715-7204

Mailing address

2078 Stadium Dr Ste 101
Bozeman, MT 59715-7204
Phone (406) 587-0810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221000926 MT Practitioner - Psychiatry 6507197142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
122486MTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Associates PC Psychiatry CurrentSince Dec 26, 2023 Accepting new patients

Locations

2078 Stadium Dr
Ste 101
Bozeman, MT 59715
Phone (406) 587-0810

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1366905929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2078 STADIUM DR STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597157204",
            "telephone_number": "406-587-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2078 STADIUM DR STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597157204",
            "telephone_number": "406-587-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHIVE",
        "first_name": "SHANNON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "122486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.