Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Carlos Carrillo, MD

Individual provider Psychiatry Physician · NPI 1114453511

Shane Carlos Carrillo, MD is a Psychiatry in Richmond, Virginia. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 2017, 9 years ago. Practices with Richmond Behavioral Health Authority, a 12-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
9
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
VA
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

107 S 5th St
Richmond, VA 23219
Phone: (804) 828-7912
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 0101265348 (VA)

Record details

NPI number1114453511
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2017
Last updated in NPPESFebruary 27, 2025
Certification dateFebruary 27, 2025
Mailing address107 S. 5th St., Richmond, VA 23219

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 2017 (9 years in practice)
Group practice Richmond Behavioral Health Authority — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Richmond