Active NPI
Shelby Pavelka
- School Psychologist
- Muncie, IN
National Provider Identifier
1952124208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 10272720
- Practice address
- 2400 W Bethel Ave
Muncie, IN 47304-2116 - Phone
- (765) 747-5290
- NPI assigned
- Nov 5, 2024
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 10272720 | IN | Primary |
Addresses
Primary practice location
2400 W Bethel Ave
Muncie, IN 47304-2116
Mailing address
4301 S Cowan Rd
Muncie, IN 47302-9448
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10272720 | IN | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1952124208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 S COWAN RD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473029448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 W BETHEL AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473042116",
"telephone_number": "765-747-5290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVELKA",
"first_name": "SHELBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-05",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IN",
"license": "10272720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.