MR. DOUGLAS E FREDERICK


Address: 1947 N Founders Cir, Wichita, KS 67206-3548
Phone: 3166134640

MR. DOUGLAS E FREDERICK (NPI# 1174528053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174528053
Entity Type Individual
Full Name MR. DOUGLAS E FREDERICK
Credential ARNP
Practice Address 1947 N Founders Cir
Wichita
KS 67206-3548
Mailing Address Po Box 8035
Wichita
KS 67208-0035
Practice Telephone 3166134640
Practice Fax Number 3166899769
Mailing Telephone 3166899135
Mailing Fax Number 3166899667
Enumeration Date 2005-06-16
Last Update Date 2014-05-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 45623 KS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OK MEDICAID 20041080A 01
KS 200278930E 05
MEDICARE 003719299 01

Office Location

Street Address 1947 N FOUNDERS CIR
City WICHITA
State KS
Zip Code 67206-3548

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114534013 Natasha Robin Moran Physical Therapy Assistant 1947 N Founders Cir, Wichita, KS 67206-3548 2020-09-25
1780290379 Aureline Stephanie Ta Nurse Anesthetist, Certified Registered 1947 N Founders Cir, Wichita, KS 67206-3548 2020-09-18
1295386266 Craig Meitler Registered Nurse 1947 N Founders Cir, Wichita, KS 67206-3548 2019-09-21
1578116091 Kaitlin Sullivan Audiologist 1947 N Founders Cir, Wichita, KS 67206-3548 2019-07-23
1972065217 Kelley Renee Ewert Occupational Therapist 1947 N Founders Cir, Wichita, KS 67206-3548 2019-04-04
1427533876 Angela Madrid Registered Nurse 1947 N Founders Cir, Wichita, KS 67206-3548 2018-10-02
1649778960 Caitlyn Coffey Nurse Practitioner 1947 N Founders Cir, Wichita, KS 67206-3548 2018-02-01
1801314745 Lauren Cote Nurse Practitioner 1947 N Founders Cir, Wichita, KS 67206-3548 2017-08-30
1497201958 Leanne Bath Occupational Therapy Assistant 1947 N Founders Cir, Wichita, KS 67206-3548 2016-08-25
1194114249 Erin Whittredge-smith Nurse Practitioner 1947 N Founders Cir, Wichita, KS 67206-3548 2015-01-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760020846 Founders Surgery Center, LLC Clinic/Center 1961 N Founders Circle, Wichita, KS 67206 2019-12-19
1174006613 Courtney Dawn Simon Physical Therapist 9360 E Central Ave Ste 100, Wichita, KS 67206 2018-09-11
1902308919 Center At Waterfront LLC Skilled Nursing Facility 1541 North Lindberg Circle, Wichita, KS 67206 2018-03-06
1750804597 Katelyn Aguiar Psychologist 250 N Rock Rd Ste 210, Wichita, KS 67206 2017-07-24
1457888778 Mona Kay Cherryholmes Social Worker 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 2017-05-17
1164899415 Elizabeth Herl Marriage & Family Therapist 250 N Rock Rd Ste 150, Wichita, KS 67206 2015-08-21
1851715510 Ndjj Corp Custodial Care Facility 6403 E Marjore, Wichita, KS 67206 2014-02-14
1801238217 Courtney Ann Lang Physical Therapist 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 2013-07-26
1194063032 Peak Performance Health Pa Chiropractor 10111 E 21st St, #106, Wichita, KS 67206 2013-01-28
1750629002 Rachel Marie Conrad Speech-Language Pathologist 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 2013-01-22
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497355473 Judith Anne Shilling Nurse Practitioner 362 N Milstead St, Wichita, KS 67212-5428 2020-10-28
1760092894 Laura Lea Aronis Nurse Practitioner 3103 N Sedgwick St, Wichita, KS 67204-4118 2020-08-04
1326663394 Evolve Diabetes LLC. Nurse Practitioner 6805 W Northwind Cir, Wichita, KS 67205-2583 2020-06-15
1619505567 Brook Moore Nurse Practitioner 328 N Mark Allen St, Wichita, KS 67212-5455 2020-03-27
1104483098 Advanced Infusion and Wellness Center, LLC Nurse Practitioner 10333 E 21st St N Ste 106, Wichita, KS 67206-3544 2019-05-25
1861978421 Celeste Delaine Grothusen Nurse Practitioner 3510 N Ridge Rd Ste 100, Wichita, KS 67205-1210 2018-07-17
1235666900 Amanda A Ewertz Nurse Practitioner 3715 N. Oliver St., Wichita, KS 67220 2017-05-12
1851672141 Keri Dawn Spencer Nurse Practitioner Heartland Home Health & Hospice, 2872 N Ridge Road Suite 122, Wichita, KS 67205-1144 2011-08-31
1558657023 Debbie Dao Nurse Practitioner 2622 W Central Ave Ste 101, Wichita, KS 67203-4970 2011-06-23
1942507785 Jill D. Crotty Nurse Practitioner 551 N Hillside St Ste 510, Wichita, KS 67214-4928 2011-02-14
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Competitor

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City WICHITA
Zip Code 67206

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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