James Allen Shadduck, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

23877 Issued in TX

Practice address

9101 N Central Expy
Suite 590
Dallas, TX 75231-5927

Phone

(214) 773-9257

NPI assigned

Jul 22, 2014

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• J. Michael Brennan, M.D., P.a.

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1669661799
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1679980676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 590",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-773-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 590",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-773-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDUCK",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "23877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sybil Sha, MD
• Aziz Shaaban
• Mohammad Shaar, M.D.
• Stephanie Shackelford, RDH
• Lauren Alexandra Shaddox, APRN, CNM
• Ronnie D Shade, M.D.
• Larry George Shadid, M.D.
• Mary Katherine Shadwick, DPT
• Keri Shafer, MD
• Paula M Shaff, DC

• Clinical Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.