Individual provider Active NPI

Robert Todd Shuman, ED.D.

  • Clinical Psychologist
  • Marblehead, MA
National Provider Identifier
1437109337
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1820 Issued in MA
Practice address
14 Tufts St
Marblehead, MA 01945-1609
Phone
(781) 631-8588
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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 1820 MA Primary

Addresses

Primary practice location

14 Tufts St
Marblehead, MA 01945-1609

Mailing address

14 Tufts St
Marblehead, MA 01945-1609
Phone (781) 631-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20130117000357 MA Practitioner - Clinical Psychologist 2264520196 Practice locations: Marblehead, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1437109337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TUFTS ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451609",
            "telephone_number": "781-631-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 TUFTS ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451609",
            "telephone_number": "781-631-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

Verify at the official NPI Registry.