Organization Active NPI

Majid a. Shams, PHD, PA

  • Clinical Psychologist
  • Wellington, FL
National Provider Identifier
1881995652
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY4959 Issued in FL
Legal business name
MAJID A. SHAMS, PHD, PA
Practice address
12788 W Forest Hill Blvd
1002
Wellington, FL 33414-4703
Phone
(561) 753-5997
NPI assigned
Nov 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Dr. Abdolmajid A Shams, PHD
Title
Owner/President
Phone
(561) 753-5997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY4959 FL Primary

Addresses

Primary practice location

12788 W Forest Hill Blvd
1002
Wellington, FL 33414-4703

Mailing address

15940 Pine Strand CT
Wellington, FL 33414-6365
Phone (561) 753-5997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101122001048 FL Part B Supplier - Clinic/Group Practice 5294921813 Receives reassigned benefits from 1 practitioner
Practice locations: Wellington, FL

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1881995652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15940 PINE STRAND CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146365",
            "telephone_number": "561-753-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12788 W FOREST HILL BLVD",
            "address_2": "1002",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144703",
            "telephone_number": "561-753-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJID A. SHAMS, PHD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "SHAMS",
        "authorized_official_first_name": "ABDOLMAJID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "561-753-5997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.