Active NPI
Shamar Marie David-Fetherson, MSW
- Behavior Analyst
- Philadelphia, PA
National Provider Identifier
1134424039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1235 Pine St
Philadelphia, PA 19107-5945 - Phone
- (215) 735-7068
- NPI assigned
- Jan 24, 2011
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1235 Pine St
Philadelphia, PA 19107-5945
Mailing address
5228 Westford Rd
Philadelphia, PA 19120-3619
Phone (215) 455-3730
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": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1134424039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5228 WESTFORD RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191203619",
"telephone_number": "215-455-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 PINE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075945",
"telephone_number": "215-735-7068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID-FETHERSON",
"first_name": "SHAMAR",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.