MR. DAVID A. PRIDDY (PHD) – Rehabilitation Psychologist, NPI 1669416749

MR. DAVID A. PRIDDY (PHD) is a healthcare provider. based in Galesburg, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 071-003839 (IL). The NPI Number for MR. DAVID A. PRIDDY (PHD) is 1669416749

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
MR. DAVID A. PRIDDY (PHD)
NPI
1669416749
Phone
(309) 343-0800
Address
575 N KELLOGG ST STE 4
Enumeration Date
16 June 2006
Last Update Date
18 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3093430800
Graduation Year
1985 (41 years ago)
PAC ID
8123027133
Group Practice PAC ID
9436473162
Professional Enrollment ID
I20061220000069
Address ID
IL614017609GA575XXSTXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for MR. DAVID A. PRIDDY (PHD)

  • 575 N KELLOGG ST STE 4

    GALESBURG, IL 614017609

    Phone: (309) 343-0800

    Fax: (309) 343-0802

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061220000069IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436473162View full group profile
NameSpecialtyState
Mental Health CounselorIL
Clinical Social WorkerIL
Mental Health CounselorIL
Mental Health CounselorIL
Clinical Social WorkerIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

Can I verify MR. DAVID A. PRIDDY (PHD) with an NPI only?
You can start verification with NPI 1669416749 for MR. DAVID A. PRIDDY (PHD), then check state licensing separately.
Can I rely on MR. DAVID A. PRIDDY (PHD) being an active provider?
As of the registry snapshot, MR. DAVID A. PRIDDY (PHD) is marked active.
What is MR. DAVID A. PRIDDY (PHD)'s primary classification?
Rehabilitation Psychologist is the headline specialty for MR. DAVID A. PRIDDY (PHD) here. Clinical services aligned with this taxonomy classification.
What area does MR. DAVID A. PRIDDY (PHD) serve?
MR. DAVID A. PRIDDY (PHD)'s listing highlights Galesburg, Illinois; more addresses can appear in NPPES.
Is the information about MR. DAVID A. PRIDDY (PHD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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