Active NPI
Loanne M Shackelford, MSW LCSW
- Clinical Social Worker
- La Veta, CO
National Provider Identifier
1902847759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 991075
- Practice address
- 200 S. Main St.
La Veta, CO 81055-0148 - Phone
- (719) 742-3372
- Fax
- (719) 742-3373
- NPI assigned
- Jun 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 Social Worker | 1041C0700X | 991075 | CO | Primary |
Addresses
Primary practice location
200 S. Main St.
La Veta, CO 81055-0148
Mailing address
PO Box 148
La Veta, CO 81055-0148
Phone (719) 742-3372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035334 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 1, 2015 through Feb 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1902847759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 148",
"city": "LA VETA",
"state": "CO",
"postal_code": "810550148",
"telephone_number": "719-742-3372",
"fax_number": "719-742-3373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S. MAIN ST.",
"city": "LA VETA",
"state": "CO",
"postal_code": "810550148",
"telephone_number": "719-742-3372",
"fax_number": "719-742-3373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "LOANNE",
"middle_name": "M",
"credential": "MSW LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "991075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035334",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Veta, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.