Active NPI
Daniel Shane Philpot, PSY.D.
- Clinical Psychologist
- Viera, FL
National Provider Identifier
1891747762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 5661
- Practice address
- 2900 Veterans Way
Viera, FL 32940-8007 - Phone
- (321) 637-3788
- NPI assigned
- May 17, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 5661 | FL | Primary |
Addresses
Primary practice location
2900 Veterans Way
Viera, FL 32940-8007
Mailing address
341 Tuscany Way Apt 109
Melbourne, FL 32940-8186
Phone (321) 536-2831
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 |
|---|---|---|---|
| PY 5661 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891747762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 TUSCANY WAY APT 109",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329408186",
"telephone_number": "321-536-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 VETERANS WAY",
"city": "VIERA",
"state": "FL",
"postal_code": "329408007",
"telephone_number": "321-637-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILPOT",
"first_name": "DANIEL",
"middle_name": "SHANE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 5661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Viera, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.