Jan Faeri, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4350 Issued in OH

Practice address

6457 Reflections Dr Ste 120
Dublin, OH 43017-2352

Phone

(614) 792-1108

Fax

(614) 792-0018

NPI assigned

Aug 10, 2006

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis and Evans LLCGroup PAC ID 1557600251, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Lewis and Evans LLC

  • Clinical Psychologist
  • Dublin, OH
  • NPI 1407310576
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1356352793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6457 REFLECTIONS DR STE 120",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172352",
            "telephone_number": "614-792-1108",
            "fax_number": "614-792-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6457 REFLECTIONS DR STE 120",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172352",
            "telephone_number": "614-792-1108",
            "fax_number": "614-792-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAERI",
        "first_name": "JAN",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-06-07",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0968538",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CP15127",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Ewert, RN
• Excalibur Hearing and Audiology
• Excelsior Nextgen Center LLC
• Eyemart Express LTD
• Ifeanyi Ezeribe
• Ashley Fagan, RBT
• Emily Fagan
• Brian P. Fahey, DO
• Andrew Fahmy, M.D.
• Gabrielle Fahrer

• Clinical Psychologist in Dublin, OH
• Providers in Dublin, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.