Individual provider Active NPI

Christopher Nicholas David, MD

  • Child & Adolescent Psychiatry Physician
  • Hermiston, OR
National Provider Identifier
1508362849
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD221814 Issued in OR
Practice address
600 NW 11TH St Ste E37
Hermiston, OR 97838-8604
Phone
(541) 667-3740
Fax
(541) 303-8743
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042-0015412 VT
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X MD221814 OR Primary

Addresses

Primary practice location

600 NW 11TH St Ste E37
Hermiston, OR 97838-8604

Mailing address

23 Ledge Way
South Burlington, VT 05403-4532
Phone (248) 885-1437

Other practice location 1

130 Fisher Rd Unit 1
Berlin, VT 05602-8132
Phone (802) 371-4392

Other practice location 2

111 Colchester Ave # Smith422
Burlington, VT 05401-1473
Phone (802) 847-3450

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230131002335 VT Practitioner - Psychiatry 5597168310 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0015412VTMDPsychiatry Physician
MD221814ORMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Vermont CurrentSince Jan 2, 2024 Accepting new patients
State of Vermont CurrentSince Jan 2, 2024 Accepting new patients
Central Vermont Medical Center Inc Psychiatry CurrentSince Jan 15, 2023 Accepting new patients
Good Shepherd Health Care System Past Accepting new patients

Locations

130 Fisher Rd
Unit 1
Berlin, VT 05602
Phone (802) 225-1743

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

111 Colchester Ave
#422
Burlington, VT 05401
Phone (802) 847-3450

350 Fisher Rd
Montpelier, VT 05633
Phone (802) 828-3300

280 State Dr
#2
Waterbury, VT 05671

Interoperability endpoints

  • Direct secure messaging: cdavid422211@direct.uvmhealth.org
  • Direct secure messaging: cdavid1515587@direct.lhs.org

Organizations & group practices 4

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1508362849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LEDGE WAY",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034532",
            "telephone_number": "248-885-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW 11TH ST STE E37",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978388604",
            "telephone_number": "541-667-3740",
            "fax_number": "541-303-8743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Fisher Rd Unit 1",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "VT",
            "postal_code": "056028132",
            "country_code": "US",
            "telephone_number": "802-371-4392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave # Smith422",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-3450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVID",
        "first_name": "CHRISTOPHER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0015412",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD221814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

Verify at the official NPI Registry.