Individual provider Active NPI

David John Carter, PSY.D

  • Psychologist
  • Winter Park, FL
National Provider Identifier
1225118094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5836 Issued in FL
Practice address
1133 Louisiana Ave
Suite 206
Winter Park, FL 32789-2350
Phone
(407) 629-1000
Fax
(407) 629-1003
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

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
Psychologist 103T00000X PY5836 FL Primary

Addresses

Primary practice location

1133 Louisiana Ave
Suite 206
Winter Park, FL 32789-2350

Mailing address

1133 Louisiana Ave
Suite 206
Winter Park, FL 32789-2350
Phone (407) 629-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000386 FL Practitioner - Psychologist Billing Independently 2163493032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1133 Louisiana Ave
Winter Park, FL 32789-2350
Phone (407) 629-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY5836FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
David Carter, Psy.D., PLLC Psychologist CurrentSince Aug 1, 2004 Accepting new patients

Locations

1133 Louisiana Ave
Ste 206
Winter Park, FL 32789
Phone (407) 629-1000

Organizations & group practices 1

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225118094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 LOUISIANA AVE",
            "address_2": "SUITE 206",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892350",
            "telephone_number": "407-629-1000",
            "fax_number": "407-629-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 LOUISIANA AVE",
            "address_2": "SUITE 206",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892350",
            "telephone_number": "407-629-1000",
            "fax_number": "407-629-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.