Individual provider Active NPI

Norman Mark Shulman, ED.D.

  • Clinical Psychologist
  • Lubbock, TX
National Provider Identifier
1568484277
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24018 Issued in TX
Practice address
4401 A 6TH St
Lubbock, TX 79416
Phone
(806) 793-7491
Fax
(806) 793-4780
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24018 TX Primary
Clinical Psychologist 103TC0700X 216 NH

Addresses

Primary practice location

4401 A 6TH St
Lubbock, TX 79416

Mailing address

4401 6TH St. a
Lubbock, TX 79416-4700
Phone (806) 793-7491

Other identifiers 1

IdentifierTypeStateIssuer
098515202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110628000677 TX Practitioner - Clinical Psychologist 5294927257 Practice locations: Lubbock, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4401 6TH St
Suite a
Lubbock, TX 79416-4700

4401 6TH St a
Lubbock, TX 79416-4700
Phone (806) 793-7491

4401 A 6TH St
Lubbock, TX 79416-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
216NHMDClinical Psychologist
24018TXMDGeneral Practice Dentistry

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1568484277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 6TH ST. A",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794164700",
            "telephone_number": "806-793-7491",
            "fax_number": "806-793-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 A 6TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79416",
            "telephone_number": "806-793-7491",
            "fax_number": "806-793-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "NORMAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24018",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098515202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.