Active NPI
Russell Federman
- Clinical Psychologist
- Charlottesville, VA
National Provider Identifier
1285972497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810002911
- Practice address
- 918 9 1/2 St NE
Charlottesville, VA 22902-5311 - Phone
- (434) 962-7495
- NPI assigned
- Jan 22, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810002911 | VA | Primary |
Addresses
Primary practice location
918 9 1/2 St NE
Charlottesville, VA 22902-5311
Mailing address
918 9 1/2 St NE
Charlottesville, VA 22902-5311
Phone (434) 962-7495
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 May 24, 2017 through May 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810002911 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358812800000",
"number": "1285972497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "918 9 1/2 ST NE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229025311",
"telephone_number": "434-962-7495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 9 1/2 ST NE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229025311",
"telephone_number": "434-962-7495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDERMAN",
"first_name": "RUSSELL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-22",
"last_updated": "2013-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810002911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.