Active NPI
Robert Todd Shuman, ED.D.
- Clinical Psychologist
- Marblehead, MA
National Provider Identifier
1437109337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1820
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.