DR. JAMES RYAN SHACKELFORD (NPI# 1639217359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639217359 |
| Entity Type | Individual |
| Full Name | DR. JAMES RYAN SHACKELFORD |
| Credential | MD |
| Practice Address |
777 N Raymond St Boise ID 83704 |
| Mailing Address |
777 N Raymond St Boise ID 83704-9251 |
| Practice Telephone | 2085142500 |
| Practice Fax Number | 2083752217 |
| Mailing Telephone | 2085142500 |
| Mailing Fax Number | 2083752217 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2019-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | NONE | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
M-13301 | ID | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
NONE | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 16th Ave N, Nampa, ID 836874058 | 2084674431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326077785 | James Hubert Shackelford | Counselor | 1113 S Milwaukee Ave, Ste 104, Libertyville, IL 60048-3758 | 2006-06-30 |
| 1649388463 | James Murray Shackelford | Dentist | 3838 N Rural St, Indianapolis, IN 46205-2930 | 2006-08-29 |
| Street Address |
777 N RAYMOND ST |
| City | BOISE |
| State | ID |
| Zip Code | 83704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566253 | Jeffrey Karl Edwards | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2005-05-24 |
| 1619599347 | Kim Mcgrath | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1437771169 | Kevin Mcnamee | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1003438730 | Tracy Adams | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1093337727 | Angela Bangs | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1902428634 | Amanda Aman | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1275155905 | Paige Ely | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1457973182 | Zara Bowden | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1992327621 | Kelsey Harding | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| 1366064099 | Jeffrey Chase | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2020-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528488905 | Alison Joy Krause | Psychiatry & Neurology | 703 South Americana Blvd #150, Boise, ID 83702 | 2014-04-23 |
| 1750704425 | Rick Dale Turner | Psychiatry & Neurology | 3818 W Catalpa Dr, Boise, ID 83703-4265 | 2014-01-30 |
| 1477996932 | Emily Patricia Hutchison | Psychiatry & Neurology | 500 W Fort St Bldg T110, Boise, ID 83702-4501 | 2013-04-14 |
| 1730408717 | Kirsten Rose Aaland | Psychiatry & Neurology | 500 W Fort St Bldg 116, Boise, ID 83702-4501 | 2010-05-31 |
| 1649597055 | Alex Brent Wills | Psychiatry & Neurology | 950 W Bannock St Ste 1100, Boise, ID 83702-6140 | 2010-04-24 |
| 1174757140 | William Terry Gipson | Psychiatry & Neurology | 10455 Jay Rd, Boise, ID 83714-9775 | 2009-05-06 |
| 1023132420 | Eric A Simmons | Psychiatry & Neurology | 335 Allumbaugh St, Boise, ID 83704-9208 | 2007-03-19 |
| 1831261544 | William K Linson | Psychiatry & Neurology | 3445 E Boulder Heights Dr, Boise, ID 83712-8565 | 2006-11-15 |
| 1720170228 | John Robert Bates | Psychiatry & Neurology | 413 N Allumbaugh St Ste 101, Boise, ID 83704-9219 | 2006-09-29 |
| 1043206683 | Barbara J. Hagen | Psychiatry & Neurology | 413 Allumbaugh St Ste 101, Boise, ID 83704-9219 | 2005-09-20 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.