Active NPI
Timothy Christian Shetter, REGISTERED PSYCHOTHE
- Counselor
- Greeley, CO
National Provider Identifier
1952550279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RP-12316
- Practice address
- 1711 61St Ave
Suite 206
Greeley, CO 80634-3046 - Phone
- (970) 599-1409
- NPI assigned
- Sep 10, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | RP-12316 | CO | Primary |
Addresses
Primary practice location
1711 61St Ave
Suite 206
Greeley, CO 80634-3046
Mailing address
1711 61St Ave
Suite 206
Greeley, CO 80634-3046
Phone (970) 599-1409
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 |
|---|---|---|---|
| RP-12316 | CO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1952550279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 61ST AVE",
"address_2": "SUITE 206",
"city": "GREELEY",
"state": "CO",
"postal_code": "806343046",
"telephone_number": "970-599-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 61ST AVE",
"address_2": "SUITE 206",
"city": "GREELEY",
"state": "CO",
"postal_code": "806343046",
"telephone_number": "970-599-1409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHETTER",
"first_name": "TIMOTHY",
"middle_name": "CHRISTIAN",
"credential": "REGISTERED PSYCHOTHE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-10",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "RP-12316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.