Individual provider Active NPI

David Profitt, ED. S.

  • School Psychologist
  • Riverside, OH
National Provider Identifier
1639593114
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
801 Old Harshman Rd
Riverside, OH 45431-1238
Phone
(937) 259-6603
NPI assigned
Feb 5, 2014
Last updated
Feb 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X NU Primary

Addresses

Primary practice location

801 Old Harshman Rd
Riverside, OH 45431-1238

Mailing address

801 Old Harshman Rd
Dayton, OH 45431-1238
Phone (937) 259-6603

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mad River Local Schools Past Accepting new patients

Organizations & group practices 1

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": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1639593114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OLD HARSHMAN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311238",
            "telephone_number": "937-259-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OLD HARSHMAN RD",
            "city": "RIVERSIDE",
            "state": "OH",
            "postal_code": "454311238",
            "telephone_number": "937-259-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFITT",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "ED. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.