John J Shumate III, MED, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710102653 Issued in VA

Practice address

9609 Jefferson Davis Hwy
North Chesterfield, VA 23237-4621

Phone

(804) 275-1116

NPI assigned

Mar 27, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Starcity Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1720789142
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1396372389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 W SOUTH BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238051924",
            "telephone_number": "804-835-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9609 JEFFERSON DAVIS HWY",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232374621",
            "telephone_number": "804-275-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMATE",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MED, CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.