Active NPI
Laura A. Shaffer, PH.D.
- Clinical Psychologist
- Charlottesville, VA
National Provider Identifier
1932326436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005210
- Practice address
- 1204 W Main St
Charlottesville, VA 22903-2824 - Phone
- (434) 924-0123
- Fax
- (434) 243-3300
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- 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 | 0810005210 | VA | Primary |
Addresses
Primary practice location
1204 W Main St
Charlottesville, VA 22903-2824
Mailing address
PO Box 9007
Charlottesville, VA 22906-9007
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201180320 | Medicaid | KS | |
| 7100296160 | Medicaid | KY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lshaffer278444@direct.healthsystem.virginia.edu | Direct |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005210 | VA | MD | Clinical Psychologist |
| 1437 | KY | MD | Clinical Social Worker |
Interoperability endpoints
- lshaffer278444@direct.healthsystem.virginia.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1932326436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9007",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229069007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 W MAIN ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229032824",
"telephone_number": "434-924-0123",
"fax_number": "434-243-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "LAURA",
"middle_name": "A.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201180320",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100296160",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lshaffer278444@direct.healthsystem.virginia.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1204 W Main St",
"city": "Charlottesville",
"state": "VA",
"country_code": "US",
"postal_code": "229032824",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.