FEDRICK GROUP, LLC (NPI# 1205071867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205071867 |
| Entity Type | Organization |
| Organization Name | FEDRICK GROUP, LLC |
| Other Organization Name | THE ATHLETE'S FOOT |
| Practice Address |
875 Lawrenceville Suwanee Rd Suite 310 Lawrenceville GA 30043-8479 |
| Practice Telephone | 6783772788 |
| Practice Fax Number | 6783772788 |
| Mailing Telephone | 6783772788 |
| Mailing Fax Number | 6783772788 |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |
| Authorized Official Name | MRS. KASINDA FEDRICK (PARTNER) |
| Authorized Official Telephone | 6783772788 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| The Athlete's Foot | Doing Business As Name - Organization |
| Street Address |
875 LAWRENCEVILLE SUWANEE RD SUITE 310 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30043-8479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463705 | Paula Lynn Gorlin | Optometrist | 875 Lawrenceville Suwanee Rd, Ste 560, Lawrenceville, GA 30043 | 2006-01-30 |
| 1083165914 | Jamie F. Fendley | Specialist | 875 Lawrenceville Suwanee Rd, Banfield Pet Hospital, Lawrenceville, GA 30043-8479 | 2016-10-15 |
| 1447623665 | Myeyedr Optometry of Georgia, LLC | Optometrist | 875 Lawrenceville Suwanee Rd, Lawrenceville, GA 30043-8479 | 2015-11-10 |
| 1700260270 | Kristina Thienthao Chen | Optometrist | 875 Lawrenceville Suwanee Rd, Lawrenceville, GA 30043-8479 | 2015-07-15 |
| 1023299575 | Gorlin Eye Associates, PC | Optometrist | 875 Lawrenceville Suwanee Rd, #560, Lawrenceville, GA 30043-8479 | 2007-11-26 |
| 1205955481 | Nutan Desai | Optometrist | 875 Lawrenceville Suwanee Rd, Lawrenceville, GA 30043-8479 | 2007-03-28 |
| 1457407405 | Laura C Davis Dds | Dentist | 875 Lawrenceville Suwanee Rd, Suite 410, Lawrenceville, GA 30043-8479 | 2007-01-25 |
| 1073626149 | Total Vision, LLC | Technician/Technologist | 875 Lawrenceville Suwanee Rd, #560, Lawrenceville, GA 30043-8479 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483882 | Brittany Javier Dunn | Counselor | 2387 Lawrenceville Huntcrest Way, Lawreneville, GA 30043 | 2020-09-30 |
| 1629614037 | Terrea Gina Bridges | Behavior Technician | 2387 Huntcrest Rd, Lawrenceville, GA 30043 | 2019-11-20 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1093299778 | Shareef Nahas | Clinical Medical Laboratory | 1130 Hurricane Shoals Rd, Suite 1800, Lawrenceville, GA 30043 | 2018-09-19 |
| 1649766874 | Nutritionecw LLC | Dietitian, Registered | 1755 North Brown Rd, Ste.200, Lawrenceville, GA 30043 | 2018-07-11 |
| 1962997965 | David Le Nguyen | Dentist | 2000 Riverside Pkwy Ste 200, Lawrenceville, GA 30043 | 2018-06-22 |
| 1932611688 | Asfc Outreach Therapeutic Counseling Services, LLC | Counselor | 1755 North Brown Road, Suite 200, Lawrenceville, GA 30043 | 2017-11-02 |
| 1518486810 | Shira Brey Williams | Specialist/Technologist | 1030 Collins Hill Rd, Lawrenceville, GA 30043 | 2017-09-18 |
| 1700300795 | Nympha J. Mathurin Meadows | Behavioral Analyst | 650 Oxford Crest Ct, Lawrenceville, GA 30043 | 2017-08-01 |
| 1992245591 | Jagruti Chaudhari | Nurse Practitioner | 855 Buford Drive, Lawrenceville, GA 30043 | 2017-03-01 |
| Find all providers in zip 30043 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503432 | Regina Murff-love | Prosthetic/Orthotic Supplier | 341 Indus Ln, Lawrenceville, GA 30044-3835 | 2019-11-26 |
| 1043738362 | Mone Ancrum | Prosthetic/Orthotic Supplier | 4245 Windale Dr, Lawrenceville, GA 30044-6869 | 2017-09-07 |
| 1225201619 | Cindy Lou Hisle LLC | Prosthetic/Orthotic Supplier | 2495 Brunswick Pike, Lawrenceville, NJ 08648-4099 | 2008-04-08 |
| 1083798458 | Ortho-p.o.d. Inc. | Prosthetic/Orthotic Supplier | 1190 Five Forks Trickum Rd, Suite 5, Lawrenceville, GA 30045-9392 | 2006-10-24 |
| 1700847100 | Big Guy Fashions Corporation | Prosthetic/Orthotic Supplier | 2495 Us Highway 1, Ste 15, Lawrenceville, NJ 08648-4099 | 2006-03-28 |
| 1194793588 | Harry J. Lawall & Son, Inc. | Prosthetic/Orthotic Supplier | 86 Franklin Corner Rd, Lawrenceville, NJ 08648-2102 | 2006-03-10 |
| 1962920215 | Fettii | Prosthetic/Orthotic Supplier | 4245 Windale Dr, Lawrenceville, GA 30044-6869 | 2017-09-07 |
| 1972910768 | Cavells Inc | Prosthetic/Orthotic Supplier | 631 Professional Dr, Suite 230, Lawrenceville, GA 30046-3367 | 2014-07-14 |
| 1568808491 | Intimates Plus LLC | Prosthetic/Orthotic Supplier | 5900 Sugarloaf Pkwy, Suite 116, Lawrenceville, GA 30043-7857 | 2013-05-19 |
| 1356610133 | Performance Spine & Sports Medicine | Prosthetic/Orthotic Supplier | 4056 Quakerbridge Rd, 111, Lawrenceville, NJ 08648-4779 | 2011-12-22 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30043 |
Please comment or provide details below to improve the information on FEDRICK GROUP, LLC.
| 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.