Active NPI
Daniel J Neller, PSYD
- Forensic Psychologist
- Fort Liberty, NC
National Provider Identifier
1811133457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 4716
- Practice address
- 2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Jan 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810005217 | VA | |
| Psychologist | 103T00000X | 1075 | SC | |
| Psychologist | 103T00000X | 3072 | GA | |
| Forensic Psychologist | 103TF0200X | 4716 | NC | Primary |
Addresses
Primary practice location
2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001
Mailing address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001
Phone (910) 907-8922
Other practice location 1
PO Box 223
Southern Pines, NC 28388
Phone (870) 740-4452
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3072 | GA | MD | Psychologist |
| 1075 | SC | MD | Psychologist |
| 0810005217 | VA | MD | Psychologist |
| 4716 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1811133457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
}
],
"practiceLocations": [
{
"address_1": "PO Box 223",
"address_purpose": "LOCATION",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "28388",
"country_code": "US",
"telephone_number": "870-740-4452",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELLER",
"first_name": "DANIEL",
"middle_name": "J",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-04",
"last_updated": "2025-02-18",
"certification_date": "2025-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810005217",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "1075",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "3072",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NC",
"license": "4716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Liberty, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.