Active NPI
David V. Baldwin, PHD
- Clinical Psychologist
- Eugene, OR
National Provider Identifier
1336352194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0815
- Practice address
- 3003 Willamette
Eugene, OR 97405 - Phone
- (541) 686-2598
- NPI assigned
- May 8, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0815 | OR | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 0815 | OR | |
| Clinical Psychologist | 103TC0700X | 0815 | OR | Primary |
Addresses
Primary practice location
3003 Willamette
Eugene, OR 97405
Mailing address
PO Box 11143
Eugene, OR 97440-3343
Phone (541) 686-2598
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J910501 | Other | OR | PSA |
| 08329000 | Other | OR | BCBS-OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0815 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292803200000",
"number": "1336352194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11143",
"city": "EUGENE",
"state": "OR",
"postal_code": "974403343",
"telephone_number": "541-686-2598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 WILLAMETTE",
"city": "EUGENE",
"state": "OR",
"postal_code": "97405",
"telephone_number": "541-686-2598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "DAVID",
"middle_name": "V.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2010-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "0815",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "OR",
"license": "0815",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "0815",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSA",
"identifier": "J910501",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-OR",
"identifier": "08329000",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.