Active NPI
David H Fordyce, PHD
- Psychologist
- Seattle, WA
National Provider Identifier
1750434379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00000928
- Practice address
- 1100 9TH Ave
Seattle, WA 98101-2756 - Phone
- (206) 223-6600
- NPI assigned
- Jan 18, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00000928 | WA | Primary |
Addresses
Primary practice location
1100 9TH Ave
Seattle, WA 98101-2756
Mailing address
1100 Olive Way MSC M4-PA
Seattle, WA 98101-1873
Phone (206) 515-5811
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8368425 | Medicaid | WA | |
| FO0456 | Other | WA | BLUE SHIELD# |
| PS709WA | Medicaid | AK | |
| 0039586 | Other | WA | LABOR AND INDUSTRIES# |
| US4127101 | Other | WA | AETNA SPECIALIST PIN |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00000928 | WA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Institute of Washington PLLC | 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.
-
- Physical Therapist
- Seattle, WA
- NPI 1457433104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1750434379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 OLIVE WAY MSC M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011873",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDYCE",
"first_name": "DAVID",
"middle_name": "H",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00000928",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8368425",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD#",
"identifier": "FO0456",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS709WA",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES#",
"identifier": "0039586",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPECIALIST PIN",
"identifier": "US4127101",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.