Individual provider Active NPI

Joshua Charles Felver, PHD ABPP

  • Clinical Child & Adolescent Psychologist
  • Ithaca, NY
National Provider Identifier
1538464417
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
021949 Issued in NY
Practice address
120 E Buffalo St
Ithaca, NY 14850-4266
Phone
(607) 233-4337
NPI assigned
Jan 24, 2011
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 021949 NY Primary

Addresses

Primary practice location

120 E Buffalo St
Ithaca, NY 14850-4266

Mailing address

120 E Buffalo St
Ithaca, NY 14850-4266
Phone (607) 233-4337

Other identifiers 1

IdentifierTypeStateIssuer
021949OtherNYNEW YORK STATE PSYCHOLOGIST REGISTRATION NUMBER

Other names 1

  • Joshua Charles Felver-Gant Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@joshfelverphd.com

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse University Past Accepting new patients

Organizations & group practices 1

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.

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": "1649376000000",
    "number": "1538464417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E BUFFALO ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504266",
            "telephone_number": "607-233-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E BUFFALO ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504266",
            "telephone_number": "607-233-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELVER",
        "first_name": "JOSHUA",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHD ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "021949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE PSYCHOLOGIST REGISTRATION NUMBER",
            "identifier": "021949",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@joshfelverphd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "27 Hungerford Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148502949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOSHUA",
            "last_name": "FELVER-GANT",
            "middle_name": "CHARLES",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.