David J Bumgarner, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000003474 Issued in TN

Practice address

2203 McKinley Rd
Johnson City, TN 37604

Phone

(423) 926-1171

NPI assigned

Dec 23, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1891024741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 MCKINLEY RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W Watauga Ave",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376045621",
            "country_code": "US",
            "telephone_number": "423-232-2600",
            "fax_number": "423-467-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUMGARNER",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-23",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000003474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Bulancea, MD
• Jerry Morgan Bullard, CRNA
• Michelle S Bullman, MD
• Yvette M Bullock, MSW
• Haley Bullough, RPH
• Alan C Bunger, PT
• Jessie Lynn Burchfield, RN
• Cynthia G Burke, CRNA
• David P Burke, PHARM.D.
• Karen Burke, FNP

• Clinical Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.