Individual provider Active NPI

Allison L Fernander, PSYD

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1629379920
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6658 Issued in OH
Practice address
9 North Edwin C Moses Blvd
Dayton, OH 45402-8470
Phone
(937) 775-4300
Fax
(937) 254-9267
NPI assigned
Nov 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6658 OH Primary

Addresses

Primary practice location

9 North Edwin C Moses Blvd
Dayton, OH 45402-8470

Mailing address

1020 Woodman Dr
Suite 225
Dayton, OH 45432-1446
Phone (937) 254-9210

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6658OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Psychological Services Association Clinical 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1629379920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR",
            "address_2": "SUITE 225",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321446",
            "telephone_number": "937-254-9210",
            "fax_number": "937-254-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NORTH EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454028470",
            "telephone_number": "937-775-4300",
            "fax_number": "937-254-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDER",
        "first_name": "ALLISON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.