Ryan Shackelford MD, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RYAN SHACKELFORD MD, PLLC

Practice address

1525 S Owyhee St
Boise, ID 83705-6014

Phone

(208) 297-3698

Fax

(208) 561-8051

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

James Ryan Shackelford, MDNPI 1639217359

Title

Psychiatrist

Phone

(208) 297-3698

Specialties & licenses 1

Addresses

Practitioners 1

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

• James Ryan Shackelford, MD

  • Psychiatry Physician
  • Boise, ID
  • NPI 1639217359
  NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1447969506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 S OWYHEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056014",
            "telephone_number": "208-297-3698",
            "fax_number": "208-561-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 S OWYHEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056014",
            "telephone_number": "208-297-3698",
            "fax_number": "208-561-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN SHACKELFORD MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "208-297-3698",
        "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": []
}

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• Catherine Winfree Ryan, MD
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• Michael J Ryan, M.D.

• Psychiatry Physician in Boise, ID
• Providers in Boise, ID by specialty
• Psychiatry Physician in Idaho

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