Individual provider Active NPI

David Glenn Rising, ED.D

  • Psychologist
  • Williamsport, PA
National Provider Identifier
1114997996
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS007680L Issued in PA
Practice address
1205 River Ave FL 2
Williamsport, PA 17701-3724
Phone
(570) 326-4118
Fax
(570) 326-5533
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS007680L PA Primary

Addresses

Primary practice location

1205 River Ave FL 2
Williamsport, PA 17701-3724

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 2

IdentifierTypeStateIssuer
1034368990001MedicaidPA
6E5001OtherPAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231205001426 PA Practitioner - Clinical Psychologist 6204284086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

1205 River Ave
Suite 2
Williamsport, PA 17701-3724
Phone (570) 326-4118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC CurrentSince Jan 1, 2024 Accepting new patients
Family Practice Center, PC Psychologist CurrentSince Jan 1, 2024 Accepting new patients

Locations

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

1205 River Ave
#2
Williamsport, PA 17701
Phone (570) 326-4118

Organizations & group practices 2

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1114997996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 RIVER AVE FL 2",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013724",
            "telephone_number": "570-326-4118",
            "fax_number": "570-326-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISING",
        "first_name": "DAVID",
        "middle_name": "GLENN",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS007680L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034368990001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6E5001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.