Individual provider Active NPI

Shannon Virtue, PSY.D.

  • Psychologist
  • Newark, DE
National Provider Identifier
1629517990
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
B1-0001088 Issued in DE
Practice address
4701 Ogletown Stanton Road
Suite 2200, Helen F. Graham Cancer Center
Newark, DE 19713-7000
Phone
(302) 623-4701
NPI assigned
Feb 19, 2017
Last updated
May 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X B1-0001088 DE Primary
Clinical Psychologist 103TC0700X PS017530 PA

Addresses

Primary practice location

4701 Ogletown Stanton Road
Suite 2200, Helen F. Graham Cancer Center
Newark, DE 19713-7000

Mailing address

200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170526000845 PA Practitioner - Clinical Psychologist 4385911171 Reassigns benefits to 1 organization
I20170526001175 DE Practitioner - Clinical Psychologist 4385911171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

100 Sunnyside Rd
Smyrna, DE 19977-1752
Phone (302) 653-1900

161 Wilmington-West Chester Pike
CCHS Concord Psychiatry
Chadds Ford, PA 19317-9041
Phone (302) 320-2100

4735 Ogletown Stanton Rd
Newark, DE 19713-2089

4735 Ogletown Stanton Rd
Newark, DE 19713-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B1-0001088DEMDPsychologist
PS017530PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Psychologist CurrentSince May 7, 2017 Accepting new patients
Christiana Care Health Services Inc CurrentSince May 7, 2017 Accepting new patients
Christiana Care Health Services Inc Current Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince May 7, 2017 Accepting new patients

Locations

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4701 Ogletown Stanton Rd
Ste 2200
Newark, DE 19713
Phone (302) 366-1200

100 Sunnyside Rd
#2
Smyrna, DE 19977
Phone (302) 653-1900

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

161 Wilmington W Chester Pike
Chadds Ford, PA 19317
Phone (610) 361-1060

161 Wilmington W Chester Pike
#P
Chadds Ford, PA 19317
Phone (610) 361-1042

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1629517990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 OGLETOWN STANTON ROAD",
            "address_2": "SUITE 2200, HELEN F. GRAHAM CANCER CENTER",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197137000",
            "telephone_number": "302-623-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRTUE",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-19",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B1-0001088",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.