DR. TERRY LEE FREDERICK (NPI# 1508997248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508997248 |
| Entity Type | Individual |
| Full Name | DR. TERRY LEE FREDERICK |
| Credential | M.D. |
| Practice Address |
2505 W Hamilton Rd S Fort Wayne IN 46814-9136 |
| Practice Telephone | 2606256200 |
| Practice Fax Number | 2606256213 |
| Mailing Telephone | 2606256200 |
| Mailing Fax Number | 2606256213 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01024046A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790152106 | Terry Frederick Sr. | Counselor | 125 S Zack Hinton Pkwy, Mcdonough, GA 30253-3335 | 2015-09-01 |
| 1891821310 | Terry Allen Frederick | Pharmacist | 1801 Main St, Jeanerette, LA 70544-3423 | 2007-02-26 |
| Street Address |
2505 W HAMILTON RD S |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46814-9136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1821229998 | Back In Action Chiropractic | Chiropractor | 10443 Llinois Road, Fort Wayne, IN 46814 | 2009-08-06 |
| 1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
| 1225287998 | George W. Bowers | Urology | 12002 Haddington Court, Fort Wayne, IN 46814 | 2008-09-17 |
| 1588831986 | Xue Zhang | Family Medicine | 10515 Illimois Rd, Fort Wayne, IN 46814 | 2008-05-14 |
| 1245449172 | Charles S Lindzy | Anesthesiology | 14104 Peddlers Ford, Fort Wayne, IN 46814 | 2007-05-21 |
| 1043338999 | Aboite Township Fire Dept In | Ambulance | 11321 Aboite Center Rd, Fort Wayne, IN 46814 | 2007-03-27 |
| 1588748206 | Lisa Renee Vachon | Chiropractor | 971 Chestnut Hills Pkwy, Ft Wayne, IN 46814 | 2006-10-25 |
| 1962586685 | Daniel Vern Velliquette | Chiropractor | 971 Chestnut Hills Parkway, Fort Wayne, IN 46814 | 2006-10-25 |
| 1336255801 | Erica L Walworth | Marriage & Family Therapist | 412 S Scott Rd, Fort Wayne, IN 46814 | 2006-08-21 |
| Find all providers in zip 46814 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760912026 | Christina A Tatara | Family Medicine | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2017-06-19 |
| 1700317633 | Robert Campbell | Family Medicine | 7411 Hope Dr, Fort Wayne, IN 46815-5687 | 2017-03-22 |
| 1487196424 | American Vein Institute LLC | Family Medicine | 10020 Dupont Circle Ct Ste 140, Fort Wayne, IN 46825-1621 | 2016-11-08 |
| 1831547124 | Anna Menze | Family Medicine | 10307 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1633 | 2016-05-27 |
| 1407203672 | Credo Health Group, LLC | Family Medicine | 10228 Dupont Circle Dr E # 100b, Fort Wayne, IN 46825-1611 | 2016-05-18 |
| 1649625104 | Gabrielle Paloma Acquaro | Family Medicine | 7806 W Jefferson Blvd Ste E, Fort Wayne, IN 46804-4180 | 2016-05-03 |
| 1720491731 | John E Marx | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807-2170 | 2014-06-06 |
| 1457763252 | Amy Simpson | Family Medicine | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | 2014-05-28 |
| 1932536083 | Clifford James Shultz | Family Medicine | 2616 Covington Pointe Trl, Fort Wayne, IN 46804-2773 | 2013-10-03 |
| 1164860086 | Andrew J Mullally | Family Medicine | 10050 Auburn Park Dr, Fort Wayne, IN 46825-2389 | 2013-06-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46814 |
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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.