Michael Garret Shumaker, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

61-1099 Issued in MS

Practice address

1151 N State St
Jackson, MS 39202-2407

Phone

(601) 352-7398

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Live Oak Psychological Associtaes

  • Clinical Psychologist
  • Jackson, MS
  • NPI 1750577805
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1053729285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST STE 212",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022467",
            "telephone_number": "601-352-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-352-7398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 Fontaine Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391575145",
            "country_code": "US",
            "telephone_number": "601-942-0596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "MICHAEL",
        "middle_name": "GARRET",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "1767",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "61-1099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Shrock, PA-C
• Josh R Shufelt, PA-C
• Mrinal Shukla, M.D.
• Gretchen S. Shull, ANP
• Grace G Shumaker, M.D.
• Amy Lee Shute, LCSW
• Xiaohong Si
• Ishaa Saleem Siddiqui
• Carey McLellan Silas, PHARMD
• Bernice Spiegel Silberman, LCSW

• Psychologist in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.