Individual provider Active NPI

Shawn Riker

  • Marriage & Family Therapist
  • Lake Mary, FL
National Provider Identifier
1609276690
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMT 1714 Issued in FL
Practice address
101 Timberlachen Cir
Suite 201
Lake Mary, FL 32746-6124
Phone
(407) 796-1232
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMT 1714 FL Primary

Addresses

Primary practice location

101 Timberlachen Cir
Suite 201
Lake Mary, FL 32746-6124

Mailing address

576 Silvergate Loop
Lake Mary, FL 32746-3742
Phone (619) 302-8898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMT 1714FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life United, LLC. Current Accepting new patients

Locations

101 Timberlachen Cir
Ste 201
Lake Mary, FL 32746
Phone (321) 262-2501

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1609276690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 SILVERGATE LOOP",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463742",
            "telephone_number": "619-302-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TIMBERLACHEN CIR",
            "address_2": "SUITE 201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466124",
            "telephone_number": "407-796-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIKER",
        "first_name": "SHAWN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT 1714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.