Individual provider Active NPI

David Wayne Pulcher, PH.D.

  • Psychologist
  • Overland Park, KS
National Provider Identifier
1598795304
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
KS#746 Issued in KS
Practice address
8575 W 110TH St Ste 200
Overland Park, KS 66210-2774
Phone
(913) 345-0033
Fax
(913) 345-0177
NPI assigned
Jul 4, 2006
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X KS LP #0746 KS
Psychologist 103T00000X PY01331 MO
Psychologist 103T00000X MO#PY01331 MO
Psychologist 103T00000X KS#746 KS Primary

Addresses

Primary practice location

8575 W 110TH St Ste 200
Overland Park, KS 66210-2774

Mailing address

8575 W 110TH St Ste 200
Overland Park, KS 66210-2774
Phone (913) 345-0033

Other identifiers 1

IdentifierTypeStateIssuer
100239720AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050630000452 MO Practitioner - Clinical Psychologist 0941246813 Reassigns benefits to 1 organization
I20051206000766 KS Practitioner - Clinical Psychologist 0941246813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8575 W 110TH St
Suite 200
Overland Park, KS 66210-2774
Phone 9133450033108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KS LP #0746KSMDPsychologist
KS#746KSMDPsychologist
MO#PY01331MOMDPsychologist
PY01331MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
David Pulcher, PH.D., LLC Psychologist CurrentSince Feb 1, 2017 Accepting new patients
Shane Jones & Associates P.a. Past Accepting new patients
Neal Barton Deutch Psychologist Past Accepting new patients
Keith Kobes, LLC PastSince Oct 10, 2021 Accepting new patients

Locations

8575 W 110th St
Ste 200
Overland Park, KS 66210
Phone (913) 345-0033

8575 W 110th St
Ste 218
Overland Park, KS 66210
Phone (913) 345-0033

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1598795304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 W 110TH ST STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102774",
            "telephone_number": "913-345-0033",
            "fax_number": "913-345-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 W 110TH ST STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102774",
            "telephone_number": "913-345-0033",
            "fax_number": "913-345-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULCHER",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-10-05",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "KS LP #0746",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "PY01331",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "MO#PY01331",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "KS#746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239720A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.