Active NPI
David B Shumway, MD
- Psychiatry Physician
- Lynn, MA
National Provider Identifier
1326069188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 37492
- Practice address
- 330 Lynnway Suite 101
Psychiatric Group of the North Shore
Lynn, MA 01901 - Phone
- (781) 595-3003
- Fax
- (781) 593-0071
- NPI assigned
- Jul 21, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 37492 | MA | Primary |
Addresses
Primary practice location
330 Lynnway Suite 101
Psychiatric Group of the North Shore
Lynn, MA 01901
Mailing address
330 Lynnway Suite 101
Psychiatric Group of the North Shore
Lynn, MA 01901
Phone (781) 595-3003
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3069711 | Medicaid | MA | |
| J05012 | Medicaid | MA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37492 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326069188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 LYNNWAY SUITE 101",
"address_2": "PSYCHIATRIC GROUP OF THE NORTH SHORE",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-595-3003",
"fax_number": "781-593-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 LYNNWAY SUITE 101",
"address_2": "PSYCHIATRIC GROUP OF THE NORTH SHORE",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-595-3003",
"fax_number": "781-593-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMWAY",
"first_name": "DAVID",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "37492",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3069711",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "J05012",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.