Individual provider Active NPI

Robert Shugoll, PH.D.

  • Psychologist
  • North Potomac, MD
National Provider Identifier
1407916257
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2094 Issued in MD
Practice address
14041 Saddle River Dr
North Potomac, MD 20878-4251
Phone
(301) 869-4657
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2094 MD Primary

Addresses

Primary practice location

14041 Saddle River Dr
North Potomac, MD 20878-4251

Mailing address

14041 Saddle River Dr
North Potomac, MD 20878-4251
Phone (301) 869-4657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20111230000353 DC Practitioner - Clinical Psychologist 4587830203 Practice locations: North Potomac, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14041 Saddle River Dr
North Potomac, MD 20878-4251
Phone (301) 412-6238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1407916257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14041 SADDLE RIVER DR",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208784251",
            "telephone_number": "301-869-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14041 SADDLE RIVER DR",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208784251",
            "telephone_number": "301-869-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUGOLL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "2094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Potomac, MD

Sources for this page

Verify at the official NPI Registry.