Individual provider Active NPI

Wanda Fedorchik

  • Counselor
  • Kearney, NE
National Provider Identifier
1962825174
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
4111 4TH Ave
Kearney, NE 68845-2878
Phone
(308) 698-0535
NPI assigned
Jan 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

4111 4TH Ave
Kearney, NE 68845-2878

Mailing address

4111 4TH Ave
Kearney, NE 68845-2878
Phone (308) 698-0535

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Behavioral Services Past Accepting new patients

Organizations & group practices 1

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": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1962825174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452878",
            "telephone_number": "308-698-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452878",
            "telephone_number": "308-698-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORCHIK",
        "first_name": "WANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.