Individual provider Active NPI

David R Fedesna, D.C.

  • Chiropractor
  • Austin, TX
National Provider Identifier
1679615520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4227TX Issued in TX
Practice address
8740 N Lamar Blvd
Austin, TX 78753-5440
Phone
(512) 835-1182
Fax
(512) 835-1888
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4227TX TX Primary

Addresses

Primary practice location

8740 N Lamar Blvd
Austin, TX 78753-5440

Mailing address

8740 N Lamar Blvd.
Austin, TX 78753-5440
Phone (512) 835-1182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000301 TX Practitioner - Chiropractic 6901961838 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5541 McNeil Dr
Austin, TX 78729-7000
Phone (512) 835-1182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4227TXTXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fedesna Chiropractic Chiropractor PastSince Jan 1, 2014 Accepting new patients
Fedesna Chiropractic Clinic Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679615520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8740 N LAMAR BLVD.",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787535440",
            "telephone_number": "512-835-1182",
            "fax_number": "512-835-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8740 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787535440",
            "telephone_number": "512-835-1182",
            "fax_number": "512-835-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDESNA",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4227TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.