Individual provider Active NPI

C David Blair, PH.D.

  • Health Service Psychologist
  • Charleston, WV
National Provider Identifier
1447206941
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
514 Issued in WV
Practice address
179 Summers St
Charleston, WV 25301-2163
Phone
(304) 342-8300
Fax
(304) 342-8311
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 514 WV Primary
Clinical Neuropsychologist 103G00000X 514 WV
Forensic Psychologist 103TF0200X 514 WV
Clinical Psychologist 103TC0700X 514 WV

Addresses

Primary practice location

179 Summers St
Charleston, WV 25301-2163

Mailing address

179 Summers St Ste 710
Charleston, WV 25301-2122
Phone (304) 342-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050926000247 WV Practitioner - Clinical Psychologist 6204860513 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Health Psychology, Inc. Clinical Neuropsychologist CurrentSince Aug 1, 2006 Accepting new patients

Locations

179 Summers St
Charleston, WV 25301
Phone (304) 342-8300

179 Summers St
Ste 710
Charleston, WV 25301
Phone (304) 342-8300

179 Summers St
Ste 706
Charleston, WV 25301

800 Nitro Market Pl
Cross Lanes, WV 25313
Phone (239) 218-8466

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1447206941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 SUMMERS ST STE 710",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012122",
            "telephone_number": "304-342-8300",
            "fax_number": "304-342-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 SUMMERS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012163",
            "telephone_number": "304-342-8300",
            "fax_number": "304-342-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "C DAVID",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "WV",
            "license": "514",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WV",
            "license": "514",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WV",
            "license": "514",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.