Organization Active NPI

David M Harvey PHD P a

  • Clinical Psychologist
  • Ponte Vedra Beach, FL
National Provider Identifier
1174783161
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 3912 Issued in FL
Legal business name
DAVID M HARVEY PHD P A
Practice address
4400 Marsh Landing Blvd
Suite 6
Ponte Vedra Beach, FL 32082-7215
Phone
(904) 280-1221
NPI assigned
Jun 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Dr. David Meriwether Harvey, PHDNPI 1922052257
Title
President
Phone
(904) 280-1221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 3912 FL Primary

Addresses

Primary practice location

4400 Marsh Landing Blvd
Suite 6
Ponte Vedra Beach, FL 32082-7215

Mailing address

4400 Marsh Landing Blvd
Suite 6
Ponte Vedra Beach, FL 32082-7215
Phone (904) 280-1221

Other identifiers 1

IdentifierTypeStateIssuer
AK149OtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080623000092 FL Part B Supplier - Clinic/Group Practice 6507937364 Receives reassigned benefits from 1 practitioner
Practice locations: Ponte Vedra Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1174783161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 6",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827215",
            "telephone_number": "904-280-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 6",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827215",
            "telephone_number": "904-280-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M HARVEY PHD P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MERIWETHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-280-1221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 3912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AK149",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.