Individual provider Active NPI

Bea David Puncochar, PH.D.

  • Clinical Psychologist
  • Brentwood, TN
National Provider Identifier
1740439017
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3097 Issued in TN
Practice address
214 Centerview Dr
Suite 290
Brentwood, TN 37027-5274
Phone
(615) 370-4977
Fax
(615) 370-9412
NPI assigned
Sep 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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 3097 TN Primary

Addresses

Primary practice location

214 Centerview Dr
Suite 290
Brentwood, TN 37027-5274

Mailing address

214 Centerview Dr
Suite 290
Brentwood, TN 37027-5274
Phone (615) 370-4977

Other names 1

  • Dr. Bieke David Puncochar Professional name

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
3097TNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1740439017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CENTERVIEW DR",
            "address_2": "SUITE 290",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275274",
            "telephone_number": "615-370-4977",
            "fax_number": "615-370-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CENTERVIEW DR",
            "address_2": "SUITE 290",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275274",
            "telephone_number": "615-370-4977",
            "fax_number": "615-370-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNCOCHAR",
        "first_name": "BEA",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BIEKE",
            "last_name": "PUNCOCHAR",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.