Adam W Shunk, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY003802 Issued in GA

Practice address

14455 Clay Terrace Blvd Ste 130
Carmel, IN 46032-3605

Phone

(317) 415-5795

NPI assigned

Apr 21, 2009

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Clinical Neuropsychologist

  Medicare reassignment NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1891939823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14455 CLAY TERRACE BLVD STE 130",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14455 CLAY TERRACE BLVD STE 130",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323605",
            "telephone_number": "317-415-5795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3855 Pleasant Hill Rd",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300961407",
            "country_code": "US",
            "telephone_number": "678-312-7880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUNK",
        "first_name": "ADAM",
        "middle_name": "W",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY003802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200939410",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam.shunk.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
            "address_1": "14455 Clay Terrace Blvd Ste 130",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460323605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Fern Shrout, D.C.
• Trace Aaron Shroyer, PA-C
• Mae Shu
• Raquel Shuff
• Zina Shulman, PHARMD
• Tracy Sickmann, PTA
• Kathleen Ann Sievert, FNP-C
• Dana Lynn Sigman
• Scott Everett Sigmund, DPT
• Signature Birth Services

• Clinical Neuropsychologist in Carmel, IN
• Providers in Carmel, IN by specialty
• Clinical Neuropsychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.