Active NPI
Daniel J Van Ingen, PSY.D.
- Psychologist
- Osprey, FL
National Provider Identifier
1649440827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY 7918
- Practice address
- 624 Oak Bay Dr
Osprey, FL 34229-8960 - Phone
- (612) 501-5358
- NPI assigned
- Mar 4, 2008
- Last updated
- Oct 12, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 7918 | FL | Primary |
| Psychologist | 103T00000X | LP5058 | MN | |
| Clinical Psychologist | 103TC0700X | 6301013662 | MI |
Addresses
Primary practice location
624 Oak Bay Dr
Osprey, FL 34229-8960
Mailing address
624 Oak Bay Dr
Osprey, FL 34229-8960
Phone (612) 501-5358
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 7918 | FL | MD | Psychologist |
| LP5058 | MN | MD | Psychologist |
| 6301013662 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286841600000",
"number": "1649440827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 OAK BAY DR",
"city": "OSPREY",
"state": "FL",
"postal_code": "342298960",
"telephone_number": "612-501-5358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 OAK BAY DR",
"city": "OSPREY",
"state": "FL",
"postal_code": "342298960",
"telephone_number": "612-501-5358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN INGEN",
"first_name": "DANIEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-04",
"last_updated": "2010-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY 7918",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5058",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301013662",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.