Active NPI
David Fejedelem
- Optician
- Streetsboro, OH
National Provider Identifier
1508564436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 5179
- Practice address
- 905 Singletary Dr
Streetsboro, OH 44241-3975 - Phone
- (330) 422-2168
- Fax
- (330) 422-2170
- NPI assigned
- Feb 20, 2023
- Last updated
- Feb 20, 2023
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 5179 | OH | Primary |
Addresses
Primary practice location
905 Singletary Dr
Streetsboro, OH 44241-3975
Mailing address
905 Singletary Dr
Streetsboro, OH 44241-3975
Phone (330) 422-2168
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5179 | OH | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1508564436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SINGLETARY DR",
"city": "STREETSBORO",
"state": "OH",
"postal_code": "442413975",
"telephone_number": "330-422-2168",
"fax_number": "330-422-2170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 SINGLETARY DR",
"city": "STREETSBORO",
"state": "OH",
"postal_code": "442413975",
"telephone_number": "330-422-2168",
"fax_number": "330-422-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEJEDELEM",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": "5179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streetsboro, OH
- Suzie Maryann Echeverria
- Serita J Eiland, LPC-MA
- Coletta Esenwein, R.N.
- Fad Managements LLC
- FC Streetsboro Heights Opco LLC
- Abdelle Ferdinand Cheres, M.D.
- Guinevere G Ferguson, CNP
- Michael Ferrara
- FHS Streetsboro, Inc. (Boulder Crossing Health and Rehabilitation)
- Five Star Export, Inc (Royal Home Health Agency)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.