Individual provider Active NPI

Edwin N Carter, PH.D.

  • Clinical Psychologist
  • Springfield, VA
National Provider Identifier
1417966474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
741 Issued in VA
Practice address
8348 Traford Lane
Suite 102
Springfield, VA 22152
Phone
(703) 569-8731
Fax
(703) 569-7248
NPI assigned
Aug 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Clinical Psychologist 103TC0700X 741 VA Primary

Addresses

Primary practice location

8348 Traford Lane
Suite 102
Springfield, VA 22152

Mailing address

8348 Traford Lane
Suite 102
Springfield, VA 22152
Phone (703) 569-8731

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090216000390 DC Practitioner - Clinical Psychologist 5991860520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Massachusetts Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinical ServicesGroup PAC ID 1254496888, 13 clinicians

Practice addresses (Care Compare)

8134 Old Keene Mill Rd
Suite 101
Springfield, VA 22152-1849
Phone 7035698731214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
741VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinical Services Clinical CurrentSince Apr 30, 2003 Accepting new patients

Locations

8348 Traford Ln
Ste 102
Springfield, VA 22152
Phone (703) 569-8731

8134 Old Keene Mill Rd
Ste 101
West Springfield, VA 22152
Phone (703) 569-8731

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417966474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8348 TRAFORD LANE",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8348 TRAFORD LANE",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-569-8731",
            "fax_number": "703-569-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "EDWIN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

Verify at the official NPI Registry.