Justin Neal Schumacher, PRC, PWS, CRM, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

19-PRC-16 Issued in OR

Practice address

173 NE 102ND Ave
Portland, OR 97220-4169

Phone

(503) 906-9995

NPI assigned

Mar 5, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Boulder Care Provider Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1699300095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11935 SE 34TH AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226819",
            "telephone_number": "260-446-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204169",
            "telephone_number": "503-906-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMACHER",
        "first_name": "JUSTIN",
        "middle_name": "NEAL",
        "credential": "PRC, PWS, CRM, PSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "19-PRC-16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "19-PRC-16",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON HEALTH AUTHORITY",
            "identifier": "THW000003153",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Schulzetenberg, PA
• Ashley Schumacher, ANP
• Caroline Louise Schumacher
• Donald Robert Schumacher, R.PH
• John P Schumacher, MD
• Natalie Marie Schumacher
• Noah Henry Schumacher, PHARMD
• Penny Schumacher, RN
• Shawn D. Schumacher, M.D.
• Earl S Schuman, MD

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.