Active NPI
David R Funk, PH.D.
- Psychologist
- Bethlehem, PA
National Provider Identifier
1902894124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS006886L
- Practice address
- 264 E Broad St
Bethlehem, PA 18018-6224 - Phone
- (610) 866-9311
- Fax
- (610) 882-2072
- NPI assigned
- Oct 11, 2005
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS006886L | PA | Primary |
Addresses
Primary practice location
264 E Broad St
Bethlehem, PA 18018-6224
Mailing address
264 E Broad St
Bethlehem, PA 18018-6224
Phone (610) 866-9311
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680012420 | Other | PA | RAIL ROAD MEDICARE |
| 276935000 | Other | PA | MAGELLAN BEHAVIORAL HEALT |
| 7497155 | Other | PA | AETNA |
| 02056702 | Other | PA | CAPITAL BLUE CROSS |
| 0523970000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 708295 | Other | PA | HIGHMARK |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255564800000",
"number": "1902894124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 E BROAD ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180186224",
"telephone_number": "610-866-9311",
"fax_number": "610-882-2072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 E BROAD ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180186224",
"telephone_number": "610-866-9311",
"fax_number": "610-882-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNK",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2009-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS006886L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "680012420",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "276935000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7497155",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "02056702",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0523970000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "708295",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.