NPIMap

Organization Active NPI

Shannon James Nurse Practitioner in Psychiatry P.C

  • Psychiatric/Mental Health Nurse Practitioner
  • Glens Falls, NY
National Provider Identifier
1417697376
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SHANNON JAMES NURSE PRACTITIONER IN PSYCHIATRY P.C
Practice address
84 Broad St Ste 2
Glens Falls, NY 12801-4381
Phone
(518) 636-5284
NPI assigned
Mar 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Shannon James, PMHNP
Title
Owner/Director
Phone
(518) 636-5284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

84 Broad St Ste 2
Glens Falls, NY 12801-4381

Mailing address

84 Broad St Ste 2
Glens Falls, NY 12801-4381
Phone (518) 636-5284

Other practice location 1

7 Stevens Street
Optional
Glens Falls, NY 12801
Phone (518) 948-0988

Other names 1

  • The Eden Center for Integrative Care Doing business as

National Provider Directory

National Provider Directory

Locations

84 Broad St
Ste 2
Glens Falls, NY 12801
Phone (518) 636-5284

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1417697376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 BROAD ST STE 2",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014381",
            "telephone_number": "518-636-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 BROAD ST STE 2",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014381",
            "telephone_number": "518-636-5284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Stevens Street",
            "address_2": "Optional",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "12801",
            "country_code": "US",
            "telephone_number": "518-948-0988",
            "fax_number": "949-798-3005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANNON JAMES NURSE PRACTITIONER IN PSYCHIATRY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-06-08",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "518-636-5284",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eden Center for Integrative Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Eden Center for Integrative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.