Active NPI
Michael L Stutts, PHD
- Clinical Psychologist
- Norfolk, VA
National Provider Identifier
1003883406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 08010001340
- Practice address
- 825 Fairfax Ave Ste 710
Norfolk, VA 23507-1914 - Phone
- (757) 446-5888
- Fax
- (757) 446-5918
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 08010001340 | VA | Primary |
Addresses
Primary practice location
825 Fairfax Ave Ste 710
Norfolk, VA 23507-1914
Mailing address
PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-8400
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000496 | Other | VA | VALUE OPTIONS |
| PAR | Other | VA | USA MANAGED CARE |
| PAR | Other | VA | FIRST HEALTH COMMERCIAL |
| 007700245 | Medicaid | VA | |
| 0367K | Other | NC | BC/BS |
| PAR | Other | VA | AETNA |
| 255618 | Other | VA | MAGELLAN HEALTH SERVICES |
| 343838 | Other | VA | MANAGED HEALTH NETWORK |
| PAR | Other | VA | MULTIPLAN |
| PAR | Other | VA | CORVEL/CORCARE |
| 215684 | Other | VA | UNITED HEALTH CARE/MAMSI |
| -006 | Other | VA | TRICARE/CHAMPUS |
| 081903 | Other | VA | ANTHEM |
| 88854 | Other | VA | SENTARA/OPTIMA |
| PAR | Other | VA | VIRGINIA PREMIER HEALTH |
| PAR | Other | VA | VIRGINIA HEALTH NETWORK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08010001340 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1003883406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235010936",
"telephone_number": "757-446-8400",
"fax_number": "757-446-8401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 FAIRFAX AVE STE 710",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071914",
"telephone_number": "757-446-5888",
"fax_number": "757-446-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTTS",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "08010001340",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "000496",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA MANAGED CARE",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH COMMERCIAL",
"identifier": "PAR",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007700245",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "0367K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH SERVICES",
"identifier": "255618",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "343838",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL/CORCARE",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE/MAMSI",
"identifier": "215684",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/CHAMPUS",
"identifier": "-006",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "081903",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA/OPTIMA",
"identifier": "88854",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER HEALTH",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA HEALTH NETWORK",
"identifier": "PAR",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.