TIM SHANNON PSYD
NPI 1407956758
Psychologist in Normal, IL

Active since September 25, 2006PECOS EnrolledAccepts Medicare Assignment
405 KAYS DR STE C, NORMAL, IL 61761(309) 664-3130(309) 664-3528 Get Directions Write a Review

NPPES record last updated: May 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tim Shannon Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIM SHANNON PSYD (NPI 1407956758) is an individual psychologist in Normal, Illinois, licensed in Illinois (071004783) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1407956758
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameTIM SHANNONCredential: PSYD
Location Address405 KAYS DR STE CNormal, IL 61761-1979
Mailing Address405 Kays Dr Ste CNormal, IL 61761-1979 · (309) 664-3130 · Fax (309) 664-3528
Fax(309) 664-3528
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateSeptember 25, 2006
Last NPPES UpdateMay 9, 2011
NPI 1407956758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071004783
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
405 KAYS DR STE C, Normal, IL 61761

Other Identifiers 7

OtherIL2613IL · Medicare Group Ptan
OtherP00820811Rr Medicare Individual
Medicare PIN204523IL
OtherDP5951Rr Medicare Group
Medicare NSC0533210001IL
Medicare UPINR17515IL
Medicare PINIL2613044IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Tim Shannon Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173658945
PECOS Enrollment IDI20100318000254
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
123 services32 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
19 services19 patients

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
405 KAYS DR STE C
NORMAL, IL 61761
Counselor (Professional)
405 KAYS DR STE C
NORMAL, IL 61761
Social Worker (Clinical)
405 KAYS DR STE C
NORMAL, IL 61761
Psychiatry & Neurology (Psychiatry)
405 KAYS DR STE C
NORMAL, IL 61761
Social Worker (Clinical)
405 KAYS DR STE C
NORMAL, IL 61761
Social Worker (Clinical)
405 KAYS DR STE C
NORMAL, IL 61761
Counselor (Mental Health)
405 KAYS DR STE C
NORMAL, IL 61761
Counselor (Mental Health)
405 KAYS DR STE C
NORMAL, IL 61761

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tim Shannon's NPI number?

The NPI number for Tim Shannon is 1407956758. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Tim Shannon located?

Tim Shannon practices at 405 Kays Dr Ste C, Normal, IL 61761. The listed phone number is (309) 664-3130.

What is Tim Shannon's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tim Shannon enrolled in Medicare?

Yes. Tim Shannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tim Shannon was last updated on May 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.