NPIMap

Organization Active NPI

Brooke Park Clinic

Doing business as Robert G. Shumaker, Ph.D.

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1295786523
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0003610 Issued in FL
Legal business name
BROOKE PARK CLINIC
Doing business as
Robert G. Shumaker, Ph.D.
Practice address
4455 NW 27TH Ave
Boca Raton, FL 33434-5830
Phone
(561) 496-0333
Fax
(561) 998-4886
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Dr. Robert Gary Shumaker, PH.D.
Title
Director
Phone
(561) 496-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY0003610 FL Primary

Addresses

Primary practice location

4455 NW 27TH Ave
Boca Raton, FL 33434-5830

Mailing address

4455 NW 27TH Ave
Boca Raton, FL 33434-5830
Phone (561) 496-0333

Other names 1

  • Robert G. Shumaker, Ph.D. Doing business as

National Provider Directory

National Provider Directory

Locations

5130 Linton Blvd
Ste B4
Delray Beach, FL 33484
Phone (561) 808-0098

2929 E Commercial Blvd
Ste 306
Ft Lauderdale, FL 33308
Phone (954) 938-3770

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1295786523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 NW 27TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334345830",
            "telephone_number": "561-496-0333",
            "fax_number": "561-998-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 NW 27TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334345830",
            "telephone_number": "561-496-0333",
            "fax_number": "561-998-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE PARK CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "SHUMAKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-496-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert G. Shumaker, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.