Active NPI
David P Fago, PH.D.
- Psychologist
- College Park, MD
National Provider Identifier
1659495885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01730
- Practice address
- 7307 Baltimore Ave
Suite 208
College Park, MD 20740-3231 - Phone
- (301) 277-3250
- Fax
- (301) 927-8052
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01730 | MD | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 01730 | MD | |
| Psychologist | 103T00000X | 1000523 | DC | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1000523 | DC | |
| Family Psychologist | 103TF0000X | 1000523 | DC | |
| Family Psychologist | 103TF0000X | 01730 | MD |
Addresses
Primary practice location
7307 Baltimore Ave
Suite 208
College Park, MD 20740-3231
Mailing address
920 Independence Ave SE
Washington, DC 20003-3918
Phone (202) 441-8823
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000523 | DC | MD | Psychologist |
| 01730 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325548800000",
"number": "1659495885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 INDEPENDENCE AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200033918",
"telephone_number": "202-441-8823",
"fax_number": "301-927-8052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7307 BALTIMORE AVE",
"address_2": "SUITE 208",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207403231",
"telephone_number": "301-277-3250",
"fax_number": "301-927-8052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGO",
"first_name": "DAVID",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2012-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "01730",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MD",
"license": "01730",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "1000523",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "DC",
"license": "1000523",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "DC",
"license": "1000523",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MD",
"license": "01730",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.