Francis J. Fishburne, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

01022 Issued in MD

Practice address

10401 Old Georgetown Rd
Suite208
Bethesda, MD 20814-1911

Phone

(240) 353-8153

Fax

(703) 938-7885

NPI assigned

Aug 7, 2007

Last updated

Aug 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Francis J. Fishburne Jr. Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1073704847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 ELMESMEADE CT",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221241746",
            "telephone_number": "240-353-8153",
            "fax_number": "703-938-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 OLD GEORGETOWN RD",
            "address_2": "SUITE208",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141911",
            "telephone_number": "240-353-8153",
            "fax_number": "703-938-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBURNE",
        "first_name": "FRANCIS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "01022",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "SC",
            "license": "1012",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRANCIS",
            "last_name": "FISHBURNE",
            "middle_name": "J.",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Neuropsychologist in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Clinical Neuropsychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.