David Leo Fedders, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01075325A Issued in IN

Practice address

1 W 4TH St
RM 2250
Cincinnati, OH 45202-3604

Phone

(513) 723-0390

Fax

(513) 723-0480

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Community Mental Health Center Inc

  • Psychiatric Hospital
  • Lawrenceburg, IN
  • NPI 1588732747
  Medicare reassignment

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1780796722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W 4TH ST",
            "address_2": "RM 2250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452023604",
            "telephone_number": "513-723-0390",
            "fax_number": "513-723-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W 4TH ST",
            "address_2": "RM 2250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452023604",
            "telephone_number": "513-723-0390",
            "fax_number": "513-723-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDERS",
        "first_name": "DAVID",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "034451",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "04451",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01075325A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0368927",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren E Feather, MS, CCC-SLP
• Jonathan Daniel Feazell, MD
• Courtney Febus, DPT
• Isaiah Febus, LSW
• Amy Feczer, RPH
• Laurel Lianne Turk Fedders, RD, LD
• Leah Ann Fede, RN
• Benjamin Tate Fedeles, M.D.
• Marlene B Feder, LPC
• Michelle Lee Federer, DO

• Psychiatry Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.