Individual provider Active NPI

Shana Parker, SC.D.

  • Psychologist
  • Boulder, CO
National Provider Identifier
1952840639
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1441 Issued in CO
Practice address
936 Rain Lilly LN
Boulder, CO 80304-0791
Phone
(303) 447-2747
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1441 CO Primary

Addresses

Primary practice location

936 Rain Lilly LN
Boulder, CO 80304-0791

Mailing address

936 Rain Lilly LN
Boulder, CO 80304-0791
Phone (303) 447-2747

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

LicenseStateTypeSpecialty
1441COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1952840639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 RAIN LILLY LN",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803040791",
            "telephone_number": "303-447-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 RAIN LILLY LN",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803040791",
            "telephone_number": "303-447-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SHANA",
        "credential": "SC.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "1441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.