Individual provider Active NPI

Robert Davis, PSY.D.

  • Clinical Psychologist
  • Hadley, MA
National Provider Identifier
1497033997
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7324 Issued in MA
Practice address
8 River Dr
Hadley, MA 01035-3540
Phone
(413) 444-0036
Fax
(413) 584-3939
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 7324 MA Primary

Addresses

Primary practice location

8 River Dr
Hadley, MA 01035-3540

Mailing address

PO Box 9
Hadley, MA 01035-0009
Phone (413) 444-0036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180410002725 MA Practitioner - Clinical Psychologist 0749560902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Russell St
Hadley, MA 01035-9570
Phone (413) 444-0036

PO Box
Suite 9
Hadley, MA 01035-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7324MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Solutions LLC Current Accepting new patients
Brain Analysis & Neurodevelopment Center, LLC PastSince Feb 18, 2016 Accepting new patients

Locations

8 River Dr
Hadley, MA 01035
Phone (413) 259-9118

Organizations & group practices 3

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1497033997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010350009",
            "telephone_number": "413-444-0036",
            "fax_number": "413-584-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RIVER DR",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010353540",
            "telephone_number": "413-444-0036",
            "fax_number": "413-584-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hadley, MA

Sources for this page

Verify at the official NPI Registry.