Richard E Shook, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1908 Issued in GA

Practice address

800 Kennesaw Ave NW Ste 320
Marietta, GA 30060-7945

Phone

(770) 514-0111

Fax

(404) 592-4648

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Richard E. Shook, PH.D., P.C.

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1588876221
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1831252220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 DUNCAN DR NW UNIT 2714",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301560465",
            "telephone_number": "770-514-0111",
            "fax_number": "404-592-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENNESAW AVE NW STE 320",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607945",
            "telephone_number": "770-514-0111",
            "fax_number": "404-592-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00577607A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Ashe Shockley, FNP-BC
• Linda Shoemaker, PHARMD
• Anita Joy Shoemo, CERTIFIED PHLEBOTOMY
• Lance David Sholes, PHARMD
• Courtney Belle Shook, LPC
• Vera Melinda Shook, LPN
• Crystal Marie Shores, RD, LD
• Savannah Lauren Short, DMD
• Sahir G Shroff, M.D.
• Shu-Re-Nu Equipment Inc. (Footlabs)

• Clinical Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.