NPIMap

Individual provider Active NPI

David Glenn Davidson-Methot, PH.D.

  • Clinical Psychologist
  • Gilbert, AZ
National Provider Identifier
1982692497
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3732 Issued in AZ
Practice address
33 N Lindsay Rd
Suite 106
Gilbert, AZ 85234-5807
Phone
(480) 262-0326
Fax
(480) 813-2706
NPI assigned
Oct 10, 2005
Last updated
Jan 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3732 AZ Primary
Clinical Psychologist 103TC0700X 18748 CA

Addresses

Primary practice location

33 N Lindsay Rd
Suite 106
Gilbert, AZ 85234-5807

Mailing address

70 S Val Vista Dr
Suite A3, #477
Gilbert, AZ 85296-1375
Phone (480) 262-0326

Other names 1

  • David Glenn Davidson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000481 CA Practitioner - Clinical Psychologist 1951325943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1230 High St
Suite 211
Auburn, CA 95603-5044
Phone (530) 210-4155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
18748CAMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Nov 16, 2012 Accepting new patients
Gilbert Individual & Family Therapy, PLLC Clinical Current Accepting new patients
Clinicas del Camino Real, Inc CurrentSince Nov 16, 2012 Accepting new patients
Sierra Hills Individual & Family Therapy Clinical CurrentSince Mar 3, 2014 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Nov 16, 2012 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Nov 16, 2012 Accepting new patients
David G Davidson-Methot, PHD, PLLC Clinical Past Accepting new patients
Clinicas del Camino Real Inc PastSince Jan 1, 1990 Accepting new patients
Arizona Interfaith Counseling Past Accepting new patients
Clinicas del Camino Real, Incorporated PastSince Jan 1, 1990 Accepting new patients

Locations

33 N Lindsay Rd
Ste 106
Gilbert, AZ 85234
Phone (480) 262-0326

70 S Val Vista Dr
Ste A3
Gilbert, AZ 85296
Phone (480) 818-4212

1230 High St
Ste 211
Auburn, CA 95603
Phone (530) 210-4155

355 Central Ave
Fillmore, CA 93015
Phone (805) 524-4926

1200 Maricopa Hwy
Ojai, CA 93023
Phone (805) 640-8293

650 Meta St
Oxnard, CA 93030
Phone (805) 487-5351

200 S Wells Rd
Ste 200
Ventura, CA 93004
Phone (805) 647-6322

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1982692497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S VAL VISTA DR",
            "address_2": "SUITE A3, #477",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961375",
            "telephone_number": "480-262-0326",
            "fax_number": "480-813-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N LINDSAY RD",
            "address_2": "SUITE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345807",
            "telephone_number": "480-262-0326",
            "fax_number": "480-813-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON-METHOT",
        "first_name": "DAVID",
        "middle_name": "GLENN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3732",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "18748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "DAVIDSON",
            "middle_name": "GLENN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.