Active NPI
Jeremy Cade Shiver, PSY.D.
- Clinical Psychologist
- College Park, GA
National Provider Identifier
1780059261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY003936
- Practice address
- 1651 Phoenix Blvd
Suite 2
College Park, GA 30349-5552 - Phone
- (770) 997-1738
- Fax
- (770) 991-1375
- NPI assigned
- Dec 9, 2015
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY003936 | GA | Primary |
Addresses
Primary practice location
1651 Phoenix Blvd
Suite 2
College Park, GA 30349-5552
Mailing address
1651 Phoenix Blvd
Suite 2
College Park, GA 30349-5552
Phone (770) 997-1738
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 |
|---|---|---|---|
| PSY003936 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven Snook, PH.D., LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- College Park, GA
- NPI 1093048324
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449619200000",
"number": "1780059261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 PHOENIX BLVD",
"address_2": "SUITE 2",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303495552",
"telephone_number": "770-997-1738",
"fax_number": "770-991-1375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 PHOENIX BLVD",
"address_2": "SUITE 2",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303495552",
"telephone_number": "770-997-1738",
"fax_number": "770-991-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVER",
"first_name": "JEREMY",
"middle_name": "CADE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-09",
"last_updated": "2015-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY003936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.