Individual provider Active NPI

Charles Christopher Fiumera, PH.D.

  • Intellectual & Developmental Disabilities Psychologist
  • Mount Vernon, OH
National Provider Identifier
1851326524
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
4983 Issued in OH
Practice address
202 S Gay St
Mount Vernon, OH 43050-3320
Phone
(740) 392-5399
Fax
(740) 392-5399
NPI assigned
Jul 11, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4983 OH
Clinical Child & Adolescent Psychologist 103TC2200X 4983 OH
Psychologist 103T00000X 4983 OH
Forensic Psychologist 103TF0200X 4983 OH
Intellectual & Developmental Disabilities Psychologist 103TM1800X 4983 OH Primary
School Psychologist 103TS0200X 4983 OH

Addresses

Primary practice location

202 S Gay St
Mount Vernon, OH 43050-3320

Mailing address

202 S Gay St
Mount Vernon, OH 43050-3320
Phone (740) 392-5399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727000120 OH Practitioner - Clinical Psychologist 3971531484 Practice locations: Mount Vernon, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4983OHMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1851326524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S GAY ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503320",
            "telephone_number": "740-392-5399",
            "fax_number": "740-392-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S GAY ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503320",
            "telephone_number": "740-392-5399",
            "fax_number": "740-392-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIUMERA",
        "first_name": "CHARLES",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "4983",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "4983",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4983",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "OH",
            "license": "4983",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "OH",
            "license": "4983",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "4983",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.