Donald Bearden, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY004019 Issued in GA

Practice address

30 Iroquois St
Unit 33
Roxbury Crossing, MA 02120-2848

Phone

(678) 612-1306

NPI assigned

Jun 30, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101
  Medicare reassignment NPD

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1508217506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 IROQUOIS ST",
            "address_2": "UNIT 33",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 IROQUOIS ST",
            "address_2": "UNIT 33",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202848",
            "telephone_number": "678-612-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY004019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Dorothy Barresi, P.T.
• Marilyn Teresa Barry, P.T.
• Deborah Bartz, M.D.
• Frederick Calvin Basilico, M.D.
• Sheila Baudin
• Sarah Kate Bearman, PH.D.
• Kathryn Blum, APRN
• Joanna Dorota Kolakowska Bolalek, MSW, LCSW
• Priscilla Dunn Bolte, NP RN
• Meryn Rita Boraski, CRNA

• Clinical Neuropsychologist in Roxbury Crossing, MA
• Providers in Roxbury Crossing, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.