Individual provider Active NPI

Ernest McFadden

  • Peer Specialist
  • Los Angeles, CA
National Provider Identifier
1104604776
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
11303 Wilshire Blvd BLDG 116
Los Angeles, CA 90025-5069
Phone
(316) 990-7046
NPI assigned
Sep 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

11303 Wilshire Blvd BLDG 116
Los Angeles, CA 90025-5069

Mailing address

11401 Vandergrift Ave
Los Angeles, CA 90025-7127
Phone (316) 990-7046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1104604776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 VANDERGRIFT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257127",
            "telephone_number": "316-990-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 WILSHIRE BLVD BLDG 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255069",
            "telephone_number": "316-990-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFADDEN",
        "first_name": "ERNEST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.