Lori Ann Shahidi, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

M9648 Issued in TX

Practice address

305 Miron Dr
Southlake, TX 76092-7831

Phone

(817) 488-1950

Fax

(817) 305-0162

NPI assigned

Apr 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1477727741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MIRON DRIVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927826",
            "telephone_number": "817-488-1950",
            "fax_number": "817-305-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927831",
            "telephone_number": "817-488-1950",
            "fax_number": "817-305-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIDI",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M9648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195601301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00736997",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X5113",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert W Sewell, MD
• Anna Catherine Sgroi
• Ty Douglas Shafer, D.D.S.
• Gunjankumar Shah, PT
• Vishal Shah, M.D.
• Alireza Allen Shakouri, MD
• Karolina Shander, PHD
• Shaner Speech Pathology
• Anita Priya Shankar, M.D.
• Nathan Shaw

• Psychiatry Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.