Johnathan August Sharrette, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60232338 Issued in WA

Practice address

2076 S Eagle Rd
Meridian, ID 83642

Phone

(208) 955-7334

Fax

(208) 955-7330

NPI assigned

Aug 29, 2012

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Neurobehavioral Health PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1518102797
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2012.

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1972852572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2076 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-955-7334",
            "fax_number": "208-955-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-955-7334",
            "fax_number": "208-955-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARRETTE",
        "first_name": "JOHNATHAN",
        "middle_name": "AUGUST",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60232338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kierstin Elizabeth Shahtout, DDS
• April Louise Shalz
• Jennifer T Shalz, MD
• Amit Sharma, MD, FACP, FASN
• Jessica Kelly Sharma, MAE
• Shaun Mar DC LLC
• Kyla Ashley Shaver, FNP
• Emma Shaw, M.A.
• Rebecca D Shaw, CFA
• Sharilyn M Shaw, LMT

• All providers in Meridian, ID
• Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.