Shanique McKittrick, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1141751 Issued in TX

Practice address

902 Preskitt Rd Ste 200
Decatur, TX 76234-4121

Phone

(940) 626-1848

Fax

(940) 626-1849

NPI assigned

Nov 16, 2023

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Haroon Siddique, MD, PAGroup PAC ID 5092874057, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CGCIBA

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.

• Haroon Siddique, MD, PA

  • Psychiatry Physician
  • Decatur, TX
  • NPI 1467614768
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1528833985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 PRESKITT RD STE 200",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762344121",
            "telephone_number": "940-626-1848",
            "fax_number": "940-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 PRESKITT RD STE 200",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762344121",
            "telephone_number": "940-626-1848",
            "fax_number": "940-626-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKITTRICK",
        "first_name": "SHANIQUE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-16",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1141751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia McCue, FNP
• Brenda Jean McDonnell, AGPCNP-BC
• Chris E McGee, MD
• McKenna Orthopaedic and Sports Medicine PA
• Randall Wade McKenna, DO
• McLean R Sanborn, MD, PA
• Sharon G McLemore, NP
• Kassi Jean McPherson, D.C., M.S.
• Michele Leane McPherson, FNP
• Kristy Meador, LPC

• Psychiatric/Mental Health Nurse Practitioner in Decatur, TX
• Providers in Decatur, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.