David W. Parks, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040984A Issued in IN

Practice address

6337 Central Ave
Portage, IN 46368-3801

Phone

(219) 763-1499

Fax

(219) 764-7025

NPI assigned

Dec 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lake Station, IN
  • NPI 1356530505

  Corporate Director

  CMS ownership
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lake Station, IN
  • NPI 1861636664

  Corporate Director

  CMS ownership

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.

• Parks Associates, P.C.

  • Clinical Psychologist
  • Portage, IN
  • NPI 1518126721
  Medicare reassignment Authorized official
• Shifting Tides, LLC

  • Clinical Psychologist
  • Portage, IN
  • NPI 1194965392
  NPD (past)

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285702548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-1499",
            "fax_number": "219-764-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-1499",
            "fax_number": "219-764-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "DAVID",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040984A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Otto, MSN, APRN, FNP-BC
• Jennifer Owen
• Chester K Pablo, P.T.
• Catalina Padilla
• Parks Associates, P.C.
• Ann Parobek, RBT
• Steven Parrott
• Kajal B Patel, APRN
• Sheel A Patel, M.D.
• Marc J Pelletier, LPT

• Clinical Psychologist in Portage, IN
• Providers in Portage, IN by specialty
• Clinical Psychologist in Indiana

• 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; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.