Individual provider Active NPI

Jeremiah Schumm, PSYCHOLOGIST

  • Psychologist
  • Dayton, OH
National Provider Identifier
1962685669
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.6612 Issued in OH
Practice address
601 South Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone
(937) 734-8333
NPI assigned
Dec 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6612 OH
Psychologist 103T00000X P.6612 OH Primary

Addresses

Primary practice location

601 South Edwin C Moses Blvd
Dayton, OH 45417-3424

Mailing address

601 South Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210915002588 OH Practitioner - Clinical Psychologist 9234535329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P.6612OHMDPsychologist
6612OHMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Behavioral Health, Inc. CurrentSince Jun 9, 2021 Accepting new patients
Samaritan Behavioral Health, Inc. Current Accepting new patients
Samaritan Behavioral Health, Inc. Current Accepting new patients

Locations

601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333

601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1962685669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SOUTH EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SOUTH EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMM",
        "first_name": "JEREMIAH",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6612",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.6612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.