Active NPI
Samuel S Dutton, PH.D., M.P.
- Prescribing (Medical) Psychologist
- Jbphh, HI
National Provider Identifier
1962476424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- MP.16
- Practice address
- 480 Central Ave
Jbphh, HI 96860-4908 - Phone
- (808) 473-0650
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | MP.16 | LA | Primary |
Addresses
Primary practice location
480 Central Ave
Jbphh, HI 96860-4908
Mailing address
480 Central Ave
Jbphh, HI 96860-4908
Phone (808) 476-0650
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MP.16 | LA | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1962476424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 CENTRAL AVE",
"city": "JBPHH",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-476-0650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 CENTRAL AVE",
"city": "JBPHH",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-473-0650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTTON",
"first_name": "SAMUEL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D., M.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "LA",
"license": "MP.16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbphh, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.