Active NPI
David A. Eardley, D.ED.
- Clinical Psychologist
- Hollidaysburg, PA
National Provider Identifier
1952414732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS003090-L
- Practice address
- 110 Bristol LN
Hollidaysburg, PA 16648-2933 - Phone
- (814) 695-7931
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | PS003090-L | PA | Primary |
Addresses
Primary practice location
110 Bristol LN
Hollidaysburg, PA 16648-2933
Mailing address
110 Bristol LN
Hollidaysburg, PA 16648-2933
Phone (814) 695-7931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001474815 0002 | Medicaid | PA |
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
- Credentials
- Doctor of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS003090-L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952414732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BRISTOL LN",
"city": "HOLLIDAYSBURG",
"state": "PA",
"postal_code": "166482933",
"telephone_number": "814-695-7931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BRISTOL LN",
"city": "HOLLIDAYSBURG",
"state": "PA",
"postal_code": "166482933",
"telephone_number": "814-695-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARDLEY",
"first_name": "DAVID",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.ED.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS003090-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001474815 0002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hollidaysburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.