Shawn Anderson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1053 Issued in KS

Practice address

8629 Bluejacket St
Suite 102
Lenexa, KS 66214-1604

Phone

(913) 677-0500

Fax

(913) 677-5243

NPI assigned

Apr 26, 2006

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.

• FSS Psychiatric, LLC

  • Psychiatry Physician
  • Lenexa, KS
  • NPI 1699730846
  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 Mar 22, 2010.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1992761944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662010674",
            "telephone_number": "913-248-9693",
            "fax_number": "913-248-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "address_2": "SUITE 102",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141604",
            "telephone_number": "913-677-0500",
            "fax_number": "913-677-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHAWN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andersen Medical Group, LLC
• Trinna Andersen
• Aaron Edward Anderson, OTR/L, CAPS, ECHM
• Ashawnte Anderson, LAC, LPCT
• Crystal Anderson
• Stephanie M Anderson, OTR/L, CLT
• Melissa Andrade
• Andrew V Herwig DDS PA
• Another Day Homecare Inc
• Martha M Antoszewski

• All providers in Lenexa, KS
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.