Alexandr Michal Federer, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

569 Issued in SC

Practice address

323 S. McQueen St
Florence, SC 29501

Phone

(843) 992-2149

Fax

(843) 992-2149

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• QHG of South Carolina Inc

  dba Carolinas Hospital System

  • Anesthesiology Physician
  • Florence, SC
  • NPI 1568476133

  Psychologist

  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1700896453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S. MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-992-2149",
            "fax_number": "843-661-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S. MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-992-2149",
            "fax_number": "843-992-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERER",
        "first_name": "ALEXANDR",
        "middle_name": "MICHAL",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "569",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0173",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Knight Fatula, MD
• Carl Alvin Faulks, M.D.
• Gabrielle Maritza-Yesenia Fauntleroy
• Brian Mark Feagin, OTRL, CHT
• Lori Womack Feagin, P.T.
• Sharmayne Federick
• Michele Lynn Feil
• Brandeis K Fennell, NP
• Matthew Eliphalet Ferguson, PT, DPT
• Patricia McDonald Ferguson, CRNA

• Clinical Psychologist in Florence, SC
• Providers in Florence, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.