Active NPI
David Andrew O'Connor, PH.D.
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1629176318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04013
- Practice address
- 10 N Greene St
Vamhcs (116/MH)
Baltimore, MD 21201-1524 - Phone
- (410) 605-7407
- Fax
- (410) 605-7931
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 04013 | MD | Primary |
Addresses
Primary practice location
10 N Greene St
Vamhcs (116/MH)
Baltimore, MD 21201-1524
Mailing address
10 N Greene St
Vamhcs (116/MH)
Baltimore, MD 21201-1524
Phone (410) 605-7407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04013 | Other | MD | PSYCHOLOGIST LICENSE NUMB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04013 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1629176318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 N GREENE ST",
"address_2": "VAMHCS (116/MH)",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011524",
"telephone_number": "410-605-7407",
"fax_number": "410-605-7931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N GREENE ST",
"address_2": "VAMHCS (116/MH)",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011524",
"telephone_number": "410-605-7407",
"fax_number": "410-605-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "DAVID",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE NUMB",
"identifier": "04013",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.