Individual provider Active NPI

Shannon McGuire, PSYD

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1528140498
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042172A Issued in IN
Practice address
7250 Clearvista Dr Ste 210
Indianapolis, IN 46256-4643
Phone
(317) 621-5719
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 20042172A IN Primary

Addresses

Primary practice location

7250 Clearvista Dr Ste 210
Indianapolis, IN 46256-4643

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2890
Phone (317) 421-2207

Other practice location 1

30 W Rampart St
Suite 120
Shelbyville, IN 46176-8846
Phone (317) 421-2207

Other identifiers 1

IdentifierTypeStateIssuer
1528140498OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20101124000651 IN Practitioner - Clinical Psychologist 5698848729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7250 Clearvista Dr
Suite 210
Indianapolis, IN 46256-4643
Phone (317) 621-1690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Mar 1, 2022 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Mar 1, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7250 Clearvista Dr
Ste 210
Indianapolis, IN 46256
Phone (317) 621-5673

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1528140498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-421-2207",
            "fax_number": "317-421-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564643",
            "telephone_number": "317-621-5719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 W Rampart St",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "IN",
            "postal_code": "461768846",
            "country_code": "US",
            "telephone_number": "317-421-2207",
            "fax_number": "317-421-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042172A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528140498",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.