Active NPI
John Morton Shroad Jr., PH.D.
- Psychologist
- Athens, OH
National Provider Identifier
1780751669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2820
- Practice address
- 14090 Mansfield Rd
Athens, OH 45701-9447 - Phone
- (740) 592-6670
- Fax
- (740) 594-2823
- NPI assigned
- Nov 29, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2820 | OH | Primary |
Addresses
Primary practice location
14090 Mansfield Rd
Athens, OH 45701-9447
Mailing address
14090 Mansfield Rd
Athens, OH 45701-9447
Phone (740) 592-6670
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2820 | OH | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780751669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14090 MANSFIELD RD",
"city": "ATHENS",
"state": "OH",
"postal_code": "457019447",
"telephone_number": "740-592-6670",
"fax_number": "740-594-2823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14090 MANSFIELD RD",
"city": "ATHENS",
"state": "OH",
"postal_code": "457019447",
"telephone_number": "740-592-6670",
"fax_number": "740-594-2823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHROAD",
"first_name": "JOHN",
"middle_name": "MORTON",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "2820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.