Active NPI
Jerome J Schultz, PH.D.
- Clinical Neuropsychologist
- Medford, MA
National Provider Identifier
1992874275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 2058
- Practice address
- 101 Presidents Landing
Ccad 1St Floor
Medford, MA 02155 - Phone
- (781) 306-8653
- Fax
- (781) 306-8646
- NPI assigned
- Nov 8, 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 2058 | MA | Primary |
Addresses
Primary practice location
101 Presidents Landing
Ccad 1St Floor
Medford, MA 02155
Mailing address
1493 Cambridge St
Ccad Station Landing
Cambridge, MA 02139-1047
Phone (781) 306-8653
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 |
|---|---|---|---|
| 2058 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992874275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"address_2": "CCAD STATION LANDING",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391047",
"telephone_number": "781-306-8653",
"fax_number": "781-306-8646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 PRESIDENTS LANDING",
"address_2": "CCAD 1ST FLOOR",
"city": "MEDFORD",
"state": "MA",
"postal_code": "02155",
"telephone_number": "781-306-8653",
"fax_number": "781-306-8646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "JEROME",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "2058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
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.