Individual provider Active NPI

David E. Loftis, PH.D.

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1730204579
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
805 Issued in GA
Practice address
2200 Century Pkwy NE
Suite 200
Atlanta, GA 30345-3103
Phone
(470) 242-1433
Fax
(470) 235-1810
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 805 GA
Clinical Psychologist 103TC0700X 805 GA Primary
Group Psychotherapy Psychologist 103TP2701X 805 GA

Addresses

Primary practice location

2200 Century Pkwy NE
Suite 200
Atlanta, GA 30345-3103

Mailing address

2200 Century Pkwy NE
Suite 200
Atlanta, GA 30345-3103
Phone (470) 242-1433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101227000035 GA Practitioner - Clinical Psychologist 8123216702 Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
805GAMDGroup Psychotherapy Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1730204579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CENTURY PKWY NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453103",
            "telephone_number": "470-242-1433",
            "fax_number": "470-235-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CENTURY PKWY NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453103",
            "telephone_number": "470-242-1433",
            "fax_number": "470-235-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIS",
        "first_name": "DAVID",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "805",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "805",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "GA",
            "license": "805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.