Organization Active NPI

Eric Diamond PHD PA

  • Clinical Psychologist
  • Gainesville, FL
National Provider Identifier
1922278183
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY3331 Issued in FL
Legal business name
ERIC DIAMOND PHD PA
Practice address
4131 NW 28TH LN
Suite 6
Gainesville, FL 32606-7432
Phone
(352) 375-3001
Fax
(352) 375-1003
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Authorized official

Name
Mr. Eric Diamond, PHDNPI 1013068584
Title
Psychologist
Phone
(352) 375-3001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY3331 FL Primary

Addresses

Primary practice location

4131 NW 28TH LN
Suite 6
Gainesville, FL 32606-7432

Mailing address

4131 NW 28TH LN
Suite 6
Gainesville, FL 32606-7432
Phone (352) 375-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000545 FL Part B Supplier - Clinic/Group Practice 8123088523 Receives reassigned benefits from 1 practitioner
Practice locations: Gainesville, FL

National Provider Directory

National Provider Directory

Locations

4131 NW 28th Ln
Ste 6
Gainesville, FL 32606
Phone (352) 318-7150

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1922278183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 NW 28TH LN",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067432",
            "telephone_number": "352-375-3001",
            "fax_number": "352-375-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 NW 28TH LN",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067432",
            "telephone_number": "352-375-3001",
            "fax_number": "352-375-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC DIAMOND PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "352-375-3001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.