Active NPI
Matthew Shumaker
- School Psychologist
- Defiance, OH
National Provider Identifier
1144640103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 20753405
- Practice address
- 28046 Watson Rd
Defiance, OH 43512-8851 - Phone
- (419) 446-2705
- NPI assigned
- Apr 17, 2014
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 20753405 | OH | Primary |
Addresses
Primary practice location
28046 Watson Rd
Defiance, OH 43512-8851
Mailing address
PO Box 53001
Pettisville, OH 43553-0001
Phone (419) 466-2705
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20753405 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397692800000",
"number": "1144640103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 53001",
"city": "PETTISVILLE",
"state": "OH",
"postal_code": "435530001",
"telephone_number": "419-466-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28046 WATSON RD",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435128851",
"telephone_number": "419-446-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMAKER",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-17",
"last_updated": "2014-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "20753405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.