Roberta Ann Shannon-Kirby, MA/CAS, LPA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3679 Issued in NC

Practice address

211-B Highway 127
75 Browning Drive Taylorsville NC 28681-6642
Hickory, NC 28602-3541

Phone

(828) 638-6681

Fax

(828) 270-7868

NPI assigned

Sep 14, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Catawba Valley Psychological Associates

  • Clinical Psychologist
  • Hickory, NC
  • NPI 1285971374
  NPD (past) Authorized official

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1518217686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211-B HIGHWAY 127",
            "address_2": "SUITE 130",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-638-6681",
            "fax_number": "828-270-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211-B HIGHWAY 127",
            "address_2": "75 BROWNING DRIVE TAYLORSVILLE NC 28681-6642",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286023541",
            "telephone_number": "828-638-6681",
            "fax_number": "828-270-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON-KIRBY",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "credential": "MA/CAS, LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nimesh Bhupendra Shah, M.D.
• Priyal Shah, MD
• Zubin Ashwin Shah, DO
• Annabelle Brannon Shamblin, BCBA
• Sayyeida Michele Shank, LCMHC
• Kimberly Louise Shaver, MSW, LCSWA
• Liza Merrill Shaw, MA, LMFT, ACHT
• Wesley Mitchell Shaw, DMD
• Laura Shaw Shely, CRNA
• Tyler Gilbert Shely III, LCSW, MSW, ACSW

• Clinical Psychologist in Hickory, NC
• Providers in Hickory, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.