Active NPI
Allison Fagan, PH.D.
- Psychologist
- Westerville, OH
National Provider Identifier
1104253152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5407
- Practice address
- 107 E College Ave
Suite 101
Westerville, OH 43081-1658 - Phone
- (614) 398-9624
- NPI assigned
- Oct 6, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5407 | Primary |
Addresses
Primary practice location
107 E College Ave
Suite 101
Westerville, OH 43081-1658
Mailing address
6575 Lake of the Woods PT
Galena, OH 43021-9616
Phone (614) 398-9624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 7, 2018 through Feb 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5407 | OH | MD | Vision Therapy Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381017600000",
"number": "1104253152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6575 LAKE OF THE WOODS PT",
"city": "GALENA",
"state": "OH",
"postal_code": "430219616",
"telephone_number": "614-398-9624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E COLLEGE AVE",
"address_2": "SUITE 101",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430811658",
"telephone_number": "614-398-9624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "ALLISON",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-06",
"last_updated": "2013-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "5407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.