Individual provider Active NPI

Thomas R Schuettge, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1255482493
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104637 Issued in MA
Practice address
319 Longwood Ave
Longwood Pediatrics
Boston, MA 02115-5728
Phone
(617) 277-7320
Fax
(617) 277-7834
NPI assigned
Jan 15, 2007
Last updated
Aug 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104637 MA Primary

Addresses

Primary practice location

319 Longwood Ave
Longwood Pediatrics
Boston, MA 02115-5728

Mailing address

319 Longwood Ave
Longwood Pediatrics
Boston, MA 02115-5728
Phone (617) 277-7320

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

State licenses

LicenseStateTypeSpecialty
104637MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1255482493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 LONGWOOD AVE",
            "address_2": "LONGWOOD PEDIATRICS",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155728",
            "telephone_number": "617-277-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 LONGWOOD AVE",
            "address_2": "LONGWOOD PEDIATRICS",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155728",
            "telephone_number": "617-277-7320",
            "fax_number": "617-277-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUETTGE",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.