Active NPI
Nathan Karl Shackelford, MSW, LSW, MPA
- Social Worker
- Montrose, CO
National Provider Identifier
1619266657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 816
- Practice address
- 314 S 6TH St
Montrose, CO 81401-5719 - Phone
- (970) 240-3208
- Fax
- (970) 240-3211
- NPI assigned
- Mar 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 816 | CO | Primary |
Addresses
Primary practice location
314 S 6TH St
Montrose, CO 81401-5719
Mailing address
314 S 6TH St
Montrose, CO 81401-5719
Phone (970) 240-3208
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
| License | State | Type | Specialty |
|---|---|---|---|
| 816 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1619266657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 S 6TH ST",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814015719",
"telephone_number": "970-240-3208",
"fax_number": "970-240-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 S 6TH ST",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814015719",
"telephone_number": "970-240-3208",
"fax_number": "970-240-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "NATHAN",
"middle_name": "KARL",
"credential": "MSW, LSW, MPA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-30",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montrose, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.