Individual provider Active NPI

David G Faulds, PSYD

  • Psychologist
  • Lincoln, NE
National Provider Identifier
1679266027
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
777 Issued in NE
Practice address
5401 South St
Lincoln, NE 68506-2150
Phone
(312) 477-1477
NPI assigned
May 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13392 NE
Psychologist 103T00000X 777 NE Primary

Addresses

Primary practice location

5401 South St
Lincoln, NE 68506-2150

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (312) 477-1477

Other practice location 1

984185 Nebraska Medical Ctr
Omaha, NE 68198-4185
Phone (312) 477-1477

Other practice location 2

17500 Burke St
Omaha, NE 68118-2244
Phone (312) 477-1477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240224000113 NE Practitioner - Mental Health Counselor 9436594991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
777NEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Jan 10, 2024 Accepting new patients

Locations

804 S 52nd St
Omaha, NE 68106
Phone (402) 559-2666

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1679266027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "312-477-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "312-477-1477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "984185 Nebraska Medical Ctr",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681984185",
            "country_code": "US",
            "telephone_number": "312-477-1477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17500 Burke St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681182244",
            "country_code": "US",
            "telephone_number": "312-477-1477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULDS",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "13392",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.