Individual provider Active NPI

David Marsh Buckingham, PHD, HSPP

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1811996945
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20040172A Issued in IN
Practice address
8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400
Phone
(317) 288-9942
Fax
(317) 288-9945
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20040172A IN Primary

Addresses

Primary practice location

8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400

Mailing address

8202 Clearvista Pkwy
Suite 6a
Indianapolis, IN 46256-1400
Phone (317) 288-9942

Other identifiers 1

IdentifierTypeStateIssuer
200015010MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100928000635 IN Practitioner - Clinical Psychologist 4486779196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Buckingham and Associates PCGroup PAC ID 9739241720, 5 clinicians

Practice addresses (Care Compare)

8202 Clearvista Pkwy
BLDG 7
Indianapolis, IN 46256-1400
Phone (317) 288-9942

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20040172AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Buckingham and Associates PC CurrentSince Sep 1, 2000 Accepting new patients

Locations

8202 Clearvista Pkwy
Bldg 7
Indianapolis, IN 46256
Phone (317) 288-9942

8202 Clearvista Pkwy
Ste 6A
Indianapolis, IN 46256
Phone (317) 288-9942

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1811996945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "SUITE 6A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "SUITE 6A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "DAVID",
        "middle_name": "MARSH",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040172A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.