Individual provider Active NPI

Amerika Feddema, CSWA

  • Clinical Social Worker
  • Lake Oswego, OR
National Provider Identifier
1922681519
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
A5191 Issued in OR
Practice address
3990 Collins Way Ste 202
Lake Oswego, OR 97035-3459
Phone
(503) 675-2830
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X A5191 OR Primary

Addresses

Primary practice location

3990 Collins Way Ste 202
Lake Oswego, OR 97035-3459

Mailing address

431 Telford Rd
Oregon City, OR 97045-3553
Phone (973) 590-9249

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A5191ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1922681519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 TELFORD RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453553",
            "telephone_number": "973-590-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY STE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353459",
            "telephone_number": "503-675-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDEMA",
        "first_name": "AMERIKA",
        "credential": "CSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A5191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.