David McGrath Baldwin Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9154 Issued in FL

Practice address

1772 Mitchell CT
Port Orange, FL 32128-6760

Phone

(802) 558-4246

NPI assigned

Jun 14, 2007

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1063616688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 MITCHELL CT",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286760",
            "telephone_number": "802-558-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 MITCHELL CT",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286760",
            "telephone_number": "802-558-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "DAVID",
        "middle_name": "MCGRATH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brook Bailey
• Karen Baker
• Lindsey Marie Baker, PMHNP
• Tyler Courtney Baker
• Jeannette Balboni
• Thomas Richard Baldwin, CRNA
• Mary Alice Ball
• Luke Banda
• Sean Michael Bannan, D.D.S.
• Melissa Barclay, PT

• Clinical Psychologist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.