BEVERLY FREDRICK (NPI# 1245633106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245633106 |
| Entity Type | Individual |
| Full Name | BEVERLY FREDRICK |
| Practice Address |
101 S Charles St Calmar IA 52132-7858 |
| Mailing Address |
Po Box 225 Decorah IA 52101-0225 |
| Practice Telephone | 5633809242 |
| Mailing Telephone | 5633809242 |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | X000705575 | 05 |
| Street Address |
101 S CHARLES ST |
| City | CALMAR |
| State | IA |
| Zip Code | 52132-7858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093231839 | Infinite Angels Home Health Inc | In Home Supportive Care | 402 E Lewis St, Calmar, IA 52132 | 2017-08-14 |
| 1104020213 | South Winneshiek Csd | Local Education Agency (LEA) | 304 S Webster Street, Calmar, IA 52132 | 2007-06-13 |
| 1649276437 | Prabhakar Pisipati | Psychiatry & Neurology | 1410 N 4th St, Clinton, IA 52132 | 2005-06-26 |
| 1245411305 | South Winneshiek Comm School | Case Management | 304 S Webster St, Calmar, IA 52132-0430 | 2007-11-16 |
| 1275784605 | Megan Joann Diaz-freed | Dentist | 205 S Webster St, Calmar, IA 52132-0818 | 2008-10-03 |
| 1477073252 | Melissa Marie Meyer | Nurse Practitioner | 106 E Main St, Calmar, IA 52132-7743 | 2017-06-22 |
| 1245646744 | Stephanie L Cenek | Nurse Practitioner | 106 E Main St, Calmar, IA 52132-7743 | 2014-07-03 |
| 1306890959 | Gundersen Clinic, Ltd. | Durable Medical Equipment & Medical Supplies | 106 E Main St, Calmar, IA 52132-7743 | 2006-05-19 |
| 1790760742 | Susan K Mcmillan | Nurse Practitioner | 106 E Main St, Box 538, Calmar, IA 52132-7743 | 2005-12-13 |
| 1710485933 | Infinite Angels Home Healthcare | In Home Supportive Care | 406 E Maple St, Po Box 382, Calmar, IA 52132-7762 | 2018-01-23 |
| Find all providers in zip 52132 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508356254 | Hope for Living LLC | Psychologist | 250 Ne 41st St Unit 206, Ankeny, IA 50021-6016 | 2018-05-17 |
| 1174013445 | Maxwell Sando | Psychologist | 250 Ne 41st Unit 260, Ankeny, IA 50021 | 2018-05-12 |
| 1689742439 | Mosaic | Psychologist | 905 Highway 69 S, Forest City, IA 50436-2100 | 2006-12-01 |
| 1720243694 | James B Knott | Psychologist | 100 Hawkins Dr, Center for Disabilities and Development, Iowa City, IA 52242-1016 | 2008-07-21 |
| 1326202482 | David P Wacker | Psychologist | 200 Hawkins Dr, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1009 | 2008-07-17 |
Please comment or provide details below to improve the information on BEVERLY FREDRICK.
| 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.