Active NPI
Richard W Shouse, P.A.
- Physician Assistant
- Thornton, CO
National Provider Identifier
1730204108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- CO1161
- Practice address
- 500 E 84TH Ave
Suite B-14
Thornton, CO 80229-5309 - Phone
- (615) 778-4066
- NPI assigned
- Mar 21, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CO1161 | CO | Primary |
Addresses
Primary practice location
500 E 84TH Ave
Suite B-14
Thornton, CO 80229-5309
Mailing address
5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone (972) 364-8000
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO1161 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255996800000",
"number": "1730204108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"address_2": "SUITE 1200 WEST",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "972-364-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E 84TH AVE",
"address_2": "SUITE B-14",
"city": "THORNTON",
"state": "CO",
"postal_code": "802295309",
"telephone_number": "615-778-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOUSE",
"first_name": "RICHARD",
"middle_name": "W",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2009-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "CO1161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.