Shorepeak Psychiatric Services, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SHOREPEAK PSYCHIATRIC SERVICES, PLLC

Practice address

4770 Baseline Rd Ste 200
Boulder, CO 80303-2668

Phone

(720) 715-8459

NPI assigned

Sep 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Abdelrahman E Selim, MDNPI 1235423302

Title

Co-Owner

Phone

(720) 715-8459

Specialties & licenses 1

Addresses

Other names 1

• ShorePeak Psychiatry and Wellness Doing business as

Locations

Practitioners 1

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

• Abdelrahman Selim, MD

  • Psychiatry Physician
  • Boulder, CO
  • NPI 1235423302
  NPD Authorized official

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632009600000",
    "number": "1427728658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032668",
            "telephone_number": "720-715-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032668",
            "telephone_number": "720-715-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREPEAK PSYCHIATRIC SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-19",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A",
        "authorized_official_last_name": "SELIM",
        "authorized_official_first_name": "ABDELRAHMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "720-715-8459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShorePeak Psychiatry and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darby Maryline Shockley, NP
• Molly Carol Shockley, RD
• Mary Shoen
• Thomas E Shonka, DPM
• Christina Joy Shore, MA
• John A Short, D.D.S.
• Laura B Shove, PT
• Milan Krishna Shrestha, MA
• Earle Shugerman, M.D.
• Lauren Shuler, IBCLC

• Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; 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.