Active NPI
David Proffitt
- Behavior Analyst
- Dallas, OR
National Provider Identifier
1487101283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 182 SW Academy St Ste 333
Dallas, OR 97338-1996 - Phone
- (503) 623-9289
- Fax
- (503) 831-9289
- NPI assigned
- Sep 9, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
182 SW Academy St Ste 333
Dallas, OR 97338-1996
Mailing address
182 SW Academy St Ste 333
Dallas, OR 97338-1996
Phone (503) 623-9289
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1487101283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 SW ACADEMY ST STE 333",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381996",
"telephone_number": "503-623-9289",
"fax_number": "503-831-1726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 SW ACADEMY ST STE 333",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381996",
"telephone_number": "503-623-9289",
"fax_number": "503-831-9289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFFITT",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.