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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 45623 | KS | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK MEDICAID | 20041080A | 01 | |
KS | 200278930E | 05 | |
MEDICARE | 003719299 | 01 |
Street Address |
1947 N FOUNDERS CIR |
City | WICHITA |
State | KS |
Zip Code | 67206-3548 |
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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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 |
Find all providers in zip 67206 |
Taxonomy Code | 363L00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
(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. |
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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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.