Individual provider Active NPI

Philip Scott Schmidt, M.S., L.M.H.C.

  • Group Psychotherapy Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1255391835
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
MH3131 Issued in FL
Practice address
16. S.E. 18TH Street
Fort Lauderdale, FL 33316-0000
Phone
(954) 462-5353
Fax
(954) 462-5393
NPI assigned
Mar 27, 2006
Last updated
Dec 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MH3131 FL
Group Psychotherapy Psychologist 103TP2701X MH3131 FL Primary

Addresses

Primary practice location

16. S.E. 18TH Street
Fort Lauderdale, FL 33316-0000

Mailing address

1716 N.E. 16TH Avenue
Fort Lauderdale, FL 33305-0000
Phone (954) 462-5353

Other identifiers 1

IdentifierTypeStateIssuer
768562900MedicaidFL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH3131FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1255391835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 N.E. 16TH AVENUE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333050000",
            "telephone_number": "954-462-5353",
            "fax_number": "954-462-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16. S.E. 18TH STREET",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333160000",
            "telephone_number": "954-462-5353",
            "fax_number": "954-462-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "PHILIP",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "M.S., L.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "MH3131",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "MH3131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768562900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.