Active NPI
Timothy D. Shumaker, M.D.
- Family Medicine Physician
- Whitfield, MS
National Provider Identifier
1376587956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11424
- Practice address
- 3550 Highway 468 West
Whitfield, MS 39193-0157 - Phone
- (601) 351-8000
- Fax
- (601) 351-8301
- NPI assigned
- Jun 15, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11424 | MS | Primary |
Addresses
Primary practice location
3550 Highway 468 West
Whitfield, MS 39193-0157
Mailing address
PO Box 157a
Whitfield, MS 39193-0157
Phone (601) 351-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00113911 | Medicaid | MS |
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 |
|---|---|---|---|
| 11424 | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291248000000",
"number": "1376587956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 157A",
"city": "WHITFIELD",
"state": "MS",
"postal_code": "391930157",
"telephone_number": "601-351-8000",
"fax_number": "601-351-8365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 HIGHWAY 468 WEST",
"city": "WHITFIELD",
"state": "MS",
"postal_code": "391930157",
"telephone_number": "601-351-8000",
"fax_number": "601-351-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMAKER",
"first_name": "TIMOTHY",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2010-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "11424",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00113911",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whitfield, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.