Active NPI
Richard Shellenberger II, PHD
- Psychologist
- London, OH
National Provider Identifier
1700292471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5275
- Practice address
- 1851 State Route 56
Madison Correctional Institution
London, OH 43140-0740 - Phone
- (740) 852-9777
- NPI assigned
- Jul 2, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5275 | OH | Primary |
Addresses
Primary practice location
1851 State Route 56
Madison Correctional Institution
London, OH 43140-0740
Mailing address
PO Box 740
London, OH 43140-0740
Phone (740) 852-9777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5275 | Other | OH | OHIO PSYCHOLOGY LICENSE NUMBER |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5275 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404259200000",
"number": "1700292471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 740",
"city": "LONDON",
"state": "OH",
"postal_code": "431400740",
"telephone_number": "740-852-9777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1851 STATE ROUTE 56",
"address_2": "MADISON CORRECTIONAL INSTITUTION",
"city": "LONDON",
"state": "OH",
"postal_code": "431400740",
"telephone_number": "740-852-9777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLENBERGER",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-02",
"last_updated": "2014-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO PSYCHOLOGY LICENSE NUMBER",
"identifier": "5275",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in London, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.