Individual provider Active NPI

Sheila Hutson, PSYD

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1306986757
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2000159807 Issued in MO
Practice address
1638C E Republic Rd
Springfield, MO 65804-6509
Phone
(417) 839-1156
Fax
(417) 882-7765
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2000159807 MO Primary

Addresses

Primary practice location

1638C E Republic Rd
Springfield, MO 65804-6509

Mailing address

1638C E Republic Rd
Springfield, MO 65804-6509
Phone (417) 839-1156

Other practice location 1

1540 E Evergreen St
Springfield, MO 65803-4300
Phone (417) 823-2900

Other identifiers 1

IdentifierTypeStateIssuer
494998016MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413000500 MO Practitioner - Clinical Psychologist 8921092933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

1540 E Evergreen St
Springfield, MO 65803-4300
Phone (417) 823-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc CurrentSince Oct 1, 2024 Accepting new patients
Primrose Nephrology, Inc. Current Accepting new patients
Sgoh Acquisition Inc CurrentSince Oct 1, 2024 Accepting new patients
Neuropsychological Associates of Southwest Missouri, P.C. Clinical PastSince Feb 1, 1997 Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

106 S Hickory St
Mount Vernon, MO 65712
Phone (417) 466-4110

101 S Main St
Rogersville, MO 65742
Phone (417) 753-9404

1540 E Evergreen St
Springfield, MO 65803
Phone (417) 823-2900

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1306986757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638C E REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046509",
            "telephone_number": "417-839-1156",
            "fax_number": "417-882-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638C E REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046509",
            "telephone_number": "417-839-1156",
            "fax_number": "417-882-7765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 E Evergreen St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658034300",
            "country_code": "US",
            "telephone_number": "417-823-2900",
            "fax_number": "417-886-2774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "SHEILA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2000159807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494998016",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.