DR. DAVID R. MOUILLE (NPI# 1134328420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134328420 |
| Entity Type | Individual |
| Full Name | DR. DAVID R. MOUILLE |
| Credential | PH.D. |
| Practice Address |
4786 Black Swan Dr Shawnee KS 66216-1235 |
| Practice Telephone | 9139626810 |
| Practice Fax Number | 9139626810 |
| Mailing Telephone | 9139626810 |
| Mailing Fax Number | 9139626810 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | PYRO327 | MO | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | 794 | KS | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PYRO327 | MO | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
794 | KS | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PYRO327 | MO | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
794 | KS | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PYRO327 | MO | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
794 | KS | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PYRO327 | MO | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
794 | KS | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
PYRO327 | MO | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
794 | KS | Behavioral Health & Social Service Providers |
| Street Address |
4786 BLACK SWAN DR |
| City | SHAWNEE |
| State | KS |
| Zip Code | 66216-1235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912431925 | Sara Fattaey | Social Worker | 7020 Constance St, Shawnee, KS 66216 | 2017-04-17 |
| 1952778631 | Martin Gale Volker | Pharmacist | 13550 W 63rd Street, Shawnee, KS 66216 | 2015-08-28 |
| 1952799827 | Susan Thomure | Physical Therapy Assistant | 6401 Long, Shawnee, KS 66216 | 2014-12-31 |
| 1144594326 | Tom Wigginton Medical, Inc. | Durable Medical Equipment & Medical Supplies | 12616 W 62nd Terr., Suite 115c, Shawnee, KS 66216 | 2012-03-06 |
| 1548572811 | Tyler Ross Young | Optometrist | 12129 Shawnee Mission Pkwy, Shawnee, KS 66216 | 2010-07-02 |
| 1689801441 | Charles Richard Ford | Ophthalmology | 4742 Black Swan Drive, Shawnee, KS 66216 | 2009-06-18 |
| 1659412237 | Carol J. Akers | Dentist | 12480 W 62nd Ter Ste 200, Shawnee, KS 66216 | 2007-02-08 |
| 1699788307 | Douglas A Anderson | Chiropractor | 12510 W 62nd Terrace, Ste #101, Shawnee, KS 66216 | 2006-08-14 |
| 1861442451 | Dayna M Brinckman | Dentist | 7407 Noland Rd, Shawnee, KS 66216 | 2006-05-12 |
| 1932164894 | Vintage Park At Lenexa LLC | Assisted Living Facility | 8710 Caenen Lake Road, Lenexa, KS 66216 | 2006-04-20 |
| Find all providers in zip 66216 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295368157 | Neuropsychology Services of Kansas | Clinical Neuropsychologist | 10111 E 21st St N Ste 401, Wichita, KS 67206-3581 | 2020-02-19 |
| 1982081162 | Adam C Parks | Clinical Neuropsychologist | 4330 Shawnee Mission Pkwy Ste 2180, Fairway, KS 66205-2522 | 2015-04-27 |
| 1275897597 | Meredith Lubow | Clinical Neuropsychologist | 14105 Stearns St, Overland Park, KS 66221-8089 | 2012-07-02 |
| 1588954200 | Jared Bruce | Clinical Neuropsychologist | 10555 Marty St Ste 100, Overland Park, KS 66212-2555 | 2011-04-14 |
| 1134274822 | Sally Ann Frutiger | Clinical Neuropsychologist | Center for Neuropsychology, University of Kansas Hospital, Kansas City, KS 66160-0001 | 2007-01-24 |
| 1477648111 | Eric Phillip Ecklund-johnson | Clinical Neuropsychologist | University of Kansas Hospital, 3901 Rainbow Blvd., Mail Stop 1059, Kansas City, KS 66160-0001 | 2006-10-04 |
| 1427061209 | Melinda Anne Shaver | Clinical Neuropsychologist | 201 N Penn Ave, Suite 507, Independence, KS 67301-3357 | 2006-08-14 |
| 1427053784 | Marc A Quillen | Clinical Neuropsychologist | 4217 Briarwood Dr, Lawrence, KS 66049-1998 | 2005-06-14 |
| 1770197790 | Amanda Brunette | Clinical Neuropsychologist | 4330 Shawnee Mission Pkwy Ste 2180, Fairway, KS 66205-2522 | 2020-09-08 |
| 1447796420 | Keith Kobes, LLC | Clinical Neuropsychologist | 8575 W. 110th St, 218, Overland Park, KS 66210-2620 | 2017-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.