Active NPI
Tucker Sweetnam Smith, PSY.D.
- Clinical Psychologist
- Bedford, MA
National Provider Identifier
1760259345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY5000233
- Practice address
- 200 Springs Rd
Bedford, MA 01730-1114 - Phone
- (781) 506-4131
- NPI assigned
- Dec 5, 2023
- 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 | PSY5000233 | MA | Primary |
Addresses
Primary practice location
200 Springs Rd
Bedford, MA 01730-1114
Mailing address
200 Springs Rd (Attn. Tucker Smith, 518/136G)
Edith Nourse Rogers Vamc
Bedford, MA 01730-1114
Phone (617) 407-2197
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY5000233 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1760259345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SPRINGS RD (ATTN. TUCKER SMITH, 518/136G)",
"address_2": "EDITH NOURSE ROGERS VAMC",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301114",
"telephone_number": "617-407-2197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SPRINGS RD",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301114",
"telephone_number": "781-506-4131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "TUCKER",
"middle_name": "SWEETNAM",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-07",
"certification_date": "2023-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "PSY5000233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.