Kaney Jervelle Fedovskiy, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

054710 Issued in GA

Practice address

80 Jesse Hill Jr Dr SE
#26024
Atlanta, GA 30303-3031

Phone

(404) 616-6689

Fax

(404) 616-0207

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kaney Jervelle Crump Former name

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Joaquin Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment
• Telecare Mental Health Services of Washington, Inc

  • Psychiatric Residential Treatment Facility
  • Tacoma, WA
  • NPI 1780913657
  Medicare reassignment

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114091469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 BOULEVARD SE",
            "address_2": "APT #E122",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303122325",
            "telephone_number": "404-441-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "address_2": "#26024",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-6689",
            "fax_number": "404-616-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOVSKIY",
        "first_name": "KANEY",
        "middle_name": "JERVELLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "054710",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A97005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANEY",
            "last_name": "CRUMP",
            "middle_name": "JERVELLE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Feather Touch Dental Care LLC
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• Jessica Lyndsey Febles, PA-C
• Ellen Federico, LCSW
• Brianna Fedorich, PA-C
• Erika Lyn Fedyk, R.N.
• Lynn M Feeman, NP
• Perry Feeman
• Amanda D Feenstra
• Laura Jane Fehrs, M.D.

• Psychiatry Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.