Shelly Marie Peltier, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

371 Issued in ND

Practice address

1300 Hospital Loop
Quentin N. Burdick Memorial Health Care Facility
Belcourt, ND 58316

Phone

(701) 477-8458

Fax

(701) 477-2509

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934
  NPD
• Spirit Lake Health Center

  • Health Service Clinic/Center
  • Fort Totten, ND
  • NPI 1073665493
  NPD (past)
• Spirit Lake Tribe

  • Health Service Clinic/Center
  • Fort Totten, ND
  • NPI 1114472891
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1467504449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL LOOP",
            "address_2": "QUENTIN N. BURDICK MEMORIAL HEALTH CARE FACILITY",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "58316",
            "telephone_number": "701-477-8458",
            "fax_number": "701-477-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL LOOP",
            "address_2": "QUENTIN N. BURDICK MEMORIAL HEALTH CARE FACILITY",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "58316",
            "telephone_number": "701-477-8458",
            "fax_number": "701-477-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "SHELLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460757",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret M Pederson, RN
• Aleta Jean Peltier, RN
• Jona Rae Peltier, LICSW
• Michelle Peltier
• Neveah Constance Peltier
• Shyann Lee Peltier
• Manh Van Pham, M.D.
• Winona Plant
• Claudette Ann Pochant
• Benjamen David Poitra, LPCC

• Clinical Psychologist in Belcourt, ND
• Providers in Belcourt, ND by specialty
• Clinical Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.