Individual provider Active NPI

David Lewis Gutterman, PH.D.

  • Clinical Psychologist
  • Greensboro, NC
National Provider Identifier
1164519187
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2267 Issued in NC
Practice address
520 N Elam Ave
Greensboro, NC 27403-1127
Phone
(336) 547-1574
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2267 NC Primary

Addresses

Primary practice location

520 N Elam Ave
Greensboro, NC 27403-1127

Mailing address

PO Box 890195
Charlotte, NC 28289-0195
Phone (336) 832-9943

Other identifiers 2

IdentifierTypeStateIssuer
69371OtherNCMEDCOST
0311WOtherNCBCBSNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20101201000997 NC Practitioner - Clinical Psychologist 2668668765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

606 Walter Reed Dr
Suite B
Greensboro, NC 27403-1114
Phone (336) 547-1574

940 Golf House CT E
Whitsett, NC 27377-9296
Phone (336) 547-1574

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. CurrentSince Feb 1, 1999 Accepting new patients
Moses Cone Medical Services, Inc. Clinical CurrentSince Feb 1, 1999 Accepting new patients
Reidsville Community Physicians Inc Past Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164519187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890195",
            "telephone_number": "336-832-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031127",
            "telephone_number": "336-547-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTERMAN",
        "first_name": "DAVID",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "69371",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0311W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.