John David Gavazzi, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS005719L Issued in PA

Practice address

890 Poplar Church Rd
Room 401
Camp Hill, PA 17011-2250

Phone

(717) 979-4550

NPI assigned

Apr 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558326025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 WINDSOR RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170506604",
            "telephone_number": "717-979-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 POPLAR CHURCH RD",
            "address_2": "ROOM 401",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112250",
            "telephone_number": "717-979-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVAZZI",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS005719L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01994201",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "641488",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Garrison
• Adrian Mauricio Garza Gangemi, MD
• Kelly Adams Garza, RN
• Safwat Albert Gassis, M.D.
• Sandra Helena Gates, LSW
• Victoria Antonette Gay, RN
• Treesha Llen Calunsod Gayoso, RN
• GDD Pharmacy Services Inc (Cumberland Apothecary LTC)
• GDD Pharmacy Services Inc. (Cumberland Apothecary)
• Fouad Adib Geadah, M.D.

• Clinical Psychologist in Camp Hill, PA
• Providers in Camp Hill, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.