Shannon Nicole Walker, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007664 Issued in IL

Practice address

9 Junction Dr W
Suite 6
Glen Carbon, IL 62034-2931

Phone

(618) 710-4123

Fax

(618) 731-4082

NPI assigned

May 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shannon Nicole Baugher Former name

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Il Institute of Behavioral Health PCGroup PAC ID 8527190206, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Southern Il Institute of Behavioral Health PC

  • Clinical Psychologist
  • Glen Carbon, IL
  • NPI 1346562881

  Clinical, IL

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1801020573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 JUNCTION DR W",
            "address_2": "SUITE 6",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620342931",
            "telephone_number": "618-710-4123",
            "fax_number": "618-731-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 JUNCTION DR W",
            "address_2": "SUITE 6",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620342931",
            "telephone_number": "618-710-4123",
            "fax_number": "618-731-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BAUGHER",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thad S Vuagniaux
• Frederick Wagner, M.D.
• Wal-Mart Stores, Inc
• Walgreen Co
• Walgreen Co.
• Stephanie Wallace, SLP
• Walmart Inc.
• Mia McKenzie Walters, PA-C
• Elizabeth Warner, MS LCPC
• Raymond K Weber, M.D.

• All providers in Glen Carbon, IL
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.