Active NPI
David Mark Woodsfellow, PHD
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1235320169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1354
- Practice address
- 2801 Buford Hwy
Ste 295
Atlanta, GA 30329-2124 - Phone
- (404) 325-3401
- Fax
- (404) 325-3401
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1354 | GA | Primary |
Addresses
Primary practice location
2801 Buford Hwy
Ste 295
Atlanta, GA 30329-2124
Mailing address
2801 Buford Hwy
Ste 295
Atlanta, GA 30329-2124
Phone (404) 325-3401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 5, 2018 through Nov 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1235320169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 BUFORD HWY",
"address_2": "STE 295",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292124",
"telephone_number": "404-325-3401",
"fax_number": "404-325-2897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 BUFORD HWY",
"address_2": "STE 295",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292124",
"telephone_number": "404-325-3401",
"fax_number": "404-325-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODSFELLOW",
"first_name": "DAVID",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "1354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.