Individual provider Active NPI

David W. Hebda, PH.D.

  • Clinical Neuropsychologist
  • Manassas, VA
National Provider Identifier
1124043419
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810002258 Issued in VA
Practice address
8140 Ashton Ave
Suite 100
Manassas, VA 20109-5698
Phone
(703) 587-8312
Fax
(703) 495-9409
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0810002258 VA Primary
Clinical Psychologist 103TC0700X 0810002258 VA

Addresses

Primary practice location

8140 Ashton Ave
Suite 100
Manassas, VA 20109-5698

Mailing address

8140 Ashton Ave
Suite 100
Manassas, VA 20109-5698
Phone (703) 587-8312

Other identifiers 1

IdentifierTypeStateIssuer
224308OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080407000253 VA Practitioner - Clinical Psychologist 1153408711 Reassigns benefits to 1 organization
Practice locations: Manassas, VA
I20200521001514 DC Practitioner - Clinical Psychologist 1153408711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10682 Crestwood Dr
Suite a
Manassas, VA 20109-4401
Phone (703) 587-8312

2000 Duke St
Suite 300
Alexandria, VA 22314-6101
Phone (703) 587-8312

510 W Braddock Rd
Alexandria, VA 22302-4101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810002258VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology of Northern Virginia Clinical CurrentSince Mar 10, 2018 Accepting new patients
Applied Neuropsychological Services, P.C. Clinical Neuropsychologist Past Accepting new patients

Locations

10682 Crestwood Dr
Ste A
Manassas, VA 20109
Phone (703) 530-0979

8140 Ashton Ave
Ste 100
Manassas, VA 20109
Phone (703) 530-0979

12007 Sunrise Valley Dr
Reston, VA 20191
Phone (703) 478-0440

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1124043419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 ASHTON AVE",
            "address_2": "SUITE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095698",
            "telephone_number": "703-587-8312",
            "fax_number": "703-495-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 ASHTON AVE",
            "address_2": "SUITE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095698",
            "telephone_number": "703-587-8312",
            "fax_number": "703-495-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBDA",
        "first_name": "DAVID",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810002258",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "224308",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.