Shamin Catherine Jaffer Ladhani, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2969-057 Issued in WI

Practice address

1320 Wisconsin Ave
Racine, WI 53403-1978

Phone

(262) 687-2699

Fax

(262) 687-2836

NPI assigned

Apr 23, 2007

Last updated

Mar 18, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Shamin Catherine Salim Jaffer Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ascension All Saints Hospital, Inc

  dba Ascension All Saints Hospital

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Medicare reassignment NPD
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Wheaton Franciscan Hospital

  • Community/Behavioral Health Agency
  • Racine, WI
  • NPI 1588970206
  Authorized official Same address or phone
• Ascension All Saints Hospital, Inc

  dba Ascension Rx 1101

  • Community/Retail Pharmacy
  • Mount Pleasant, WI
  • NPI 1164522132
  NPD

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1437377900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 PACIFIC CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600905154",
            "telephone_number": "847-873-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2699",
            "fax_number": "262-687-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADHANI",
        "first_name": "SHAMIN",
        "middle_name": "CATHERINE JAFFER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2969-057",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAMIN",
            "last_name": "JAFFER",
            "middle_name": "CATHERINE SALIM",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.