S. Christopher Shim, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01035698A Issued in IN

Practice address

415 E Cook Rd Ste 500
Fort Wayne, IN 46825-3657

Phone

(260) 969-9696

Fax

(260) 969-7979

NPI assigned

Aug 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professional Psychiatric Services, LLC

  • Psychiatry Physician
  • Fort Wayne, IN
  • NPI 1407166077
  Authorized official Same address or phone
• Bluffton Physician Services LLC

  • Internal Medicine Physician
  • Bluffton, IN
  • NPI 1497153522
  NPD (past)
• Caylor Nickel Clinic, PC

  • Multi-Specialty Clinic/Center
  • Bluffton, IN
  • NPI 1669424784
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588676415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 W SYCAMORE HILLS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149308",
            "telephone_number": "260-615-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E COOK RD STE 500",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253657",
            "telephone_number": "260-969-9696",
            "fax_number": "260-969-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "S.",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01035698A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth L. Shields, LMHC
• Shirley F Shiff, PSYD HSPP
• Kathi Shifferly, REGISTRED NURSE
• Eugene Yu Sheng Shih, M.D.
• Brian Shilts, MS, LMHC, CSAYC
• Hahns L Shin, MD
• Shining Steps ABA of Indiana LLC
• Lakan Nicholle Shippy, LCSW
• Jonathan T Shirazi, M.D.
• Amruta Shirbhate

• Psychiatry Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.