Shannon C Alexander, PHD
Individual provider Active NPI Clinical Psychologist · Jamestown, ND
NPI 1528397288 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1528397288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 30687 (CA)
- Practice address
- 715 10TH St SE
Jamestown, ND 58401-5728 - Phone
- (701) 952-9600
- Fax
- (701) 952-9601
- NPI assigned
- Dec 9, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- P R Health Corporation
Practice addresses (Care Compare)
115 Vivian St W
Park River, ND 58270-4540
Phone (701) 284-7500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140626000625 | ND | Practitioner - Clinical Psychologist | 0244497527 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30687 | CA | MD | Dentist |
| 446 | ND | MD | General Acute Care Hospital |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benson Psychological Services PC | Current |
Accepting new patients | |
| North Central Behavioral Health Clinic | Current |
Accepting new patients | |
| Inspired Healthcare, PLLC | Current |
Accepting new patients | |
| Badlands Behavioral Health Clinic | Current |
Accepting new patients | |
| P R Health Corporation | Current | Accepting new patients | |
| Badlands Behavioral Health Clinic | Past | Accepting new patients |
Locations
600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644
1200 Roberts Ave NE
Cooperstown, ND 58425
Phone (701) 797-2128
1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500
1020 36th St SW
Ste C
Fargo, ND 58103
Phone (701) 297-7540
715 10th St SE
Jamestown, ND 58401
Phone (701) 252-9852
1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychologist | 103T00000X | 446 | ND | |
| Clinical Psychologist | 103TC0700X | 30687 | CA | Yes |
Addresses
Primary practice location
715 10TH St SE
Jamestown, ND 58401-5728
Mailing address
715 10TH St SE
Jamestown, ND 58401-5728
Phone (701) 952-9600
Other names
- Shannon C Lura
Other providers in Jamestown, ND
- Farahan Ibrahim Aden
- Fnu Ahadujjaman
- Ann Marie Albrecht
- Annmarie Joy Aldinger
- Jennifer Aldinger
- Angela Marie Allmer
- Alpha Opportunities Inc.
- Alpha Opportunities, Inc.
- Alpha Opportunities, Inc.
- Alpha Opportunities, Inc.
All providers in Jamestown, ND · Clinical Psychologist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.