Individual provider Active NPI

David Edward Burkhead, ED.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1669477212
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2090 Issued in FL
Practice address
1919 NE 45TH St
Ste 121
Fort Lauderdale, FL 33308-5135
Phone
(954) 491-6163
Fax
(954) 491-4255
NPI assigned
Jun 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2090 FL Primary

Addresses

Primary practice location

1919 NE 45TH St
Ste 121
Fort Lauderdale, FL 33308-5135

Mailing address

1919 NE 45TH St
Ste 121
Fort Lauderdale, FL 33308-5135
Phone (954) 491-6163

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

LicenseStateTypeSpecialty
PY2090FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Counseling & Consulting 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669477212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NE 45TH ST",
            "address_2": "STE 121",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085135",
            "telephone_number": "954-491-6163",
            "fax_number": "954-491-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NE 45TH ST",
            "address_2": "STE 121",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085135",
            "telephone_number": "954-491-6163",
            "fax_number": "954-491-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHEAD",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.