Individual provider Active NPI

David Dean Nowell, PH.D.

  • Clinical Psychologist
  • Worcester, MA
National Provider Identifier
1790821411
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7226 Issued in MA
Practice address
189 May St
Fairlawn Hospital
Worcester, MA 01602-4339
Phone
(508) 471-9254
Fax
(508) 885-8989
NPI assigned
Jan 29, 2007
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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 7226 MA Primary

Addresses

Primary practice location

189 May St
Fairlawn Hospital
Worcester, MA 01602-4339

Mailing address

189 May St
Fairlawn Hospital
Worcester, MA 01602-4339
Phone (508) 471-9254

Other identifiers 1

IdentifierTypeStateIssuer
1894579MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20100913000650 MA Practitioner - Clinical Psychologist 8628193794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

189 May St
Worcester, MA 01602-4339
Phone (508) 471-9254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7226MAMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Nowell Neuropsychological Services, Inc. Clinical CurrentSince Jan 1, 2012 Accepting new patients

Locations

189 May St
Worcester, MA 01602
Phone (508) 471-9254

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1790821411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 MAY ST",
            "address_2": "FAIRLAWN HOSPITAL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016024339",
            "telephone_number": "508-471-9254",
            "fax_number": "508-885-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 MAY ST",
            "address_2": "FAIRLAWN HOSPITAL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016024339",
            "telephone_number": "508-471-9254",
            "fax_number": "508-885-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWELL",
        "first_name": "DAVID",
        "middle_name": "DEAN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1894579",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.