FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC (NPI# 1548596927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548596927 |
| Entity Type | Organization |
| Organization Name | FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC |
| Practice Address |
115 Schult Ridge Rd Fredericksburg IA 50630-9582 |
| Practice Telephone | 5632375316 |
| Mailing Telephone | 5632375316 |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |
| Authorized Official Name | DR. LUCAS BRINKMAN (OWNER) |
| Authorized Official Telephone | 5632375316 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
3824 | IA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0130401 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC | 115 Schult Ridge Road, Fredericksburg, IA 50630 |
| Street Address |
115 SCHULT RIDGE RD |
| City | FREDERICKSBURG |
| State | IA |
| Zip Code | 50630-9582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316107 | Mary Sharon Peraud | Family Medicine | 115 Schult Ridge Rd, Fredericksburg, IA 50630-9582 | 2005-09-15 |
| 1811003031 | Lucas Brinkman | Emergency Medicine | 115 Schult Ridge Rd, Fredericksburg, IA 50630-9582 | 2006-08-21 |
| 1326085739 | Fredericksburg Family Health Clinic | Family Medicine | 115 Schult Ridge Rd, Fredericksburg, IA 50630-9582 | 2006-06-02 |
| 1083609044 | Joseph Bernard Peraud | Family Medicine | 115 Schult Ridge Rd, Fredericksburg, IA 50630-9582 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154463081 | Chickasaw Ambulance Service Inc | Ambulance | 121 Buckeye Street, Fredericksburg, IA 50630 | 2007-02-14 |
| 1205838687 | Steven William Horak | Chiropractor | 111 West Main Street, Fredericksburg, IA 50630 | 2005-08-15 |
| 1447582390 | Pathways Behavioral Services Inc | Community/Behavioral Health | 602 S Washington Ave, Fredericksburg, IA 50630-1003 | 2010-02-03 |
| 1396376414 | Molly Barbara Demuth | Counselor | 602 S Washington Ave, Fredericksburg, IA 50630-1003 | 2020-01-28 |
| 1942611751 | Lacey Schmitt | Counselor | 602 S Washington Ave, Fredericksburg, IA 50630-1003 | 2014-05-14 |
| 1922320084 | Pathways Behavioral Services Inc | Substance Abuse Rehabilitation Facility | 602 S Washington Ave, Fredericksburg, IA 50630-1003 | 2010-02-17 |
| 1033438809 | Jillian Jolley | Doula | 205 S Washington Ave, Fredericksburg, IA 50630-1036 | 2010-05-19 |
| 1386811321 | Laurie Danae Thein | Counselor | 123 E Main St, Fredericksburg, IA 50630-7701 | 2008-05-09 |
| 1184808081 | Fredericksburg Comm School District | Local Education Agency (LEA) | 401 E High St, Fredericksburg, IA 50630-7730 | 2007-12-27 |
| 1649530924 | Shelley Carter | Military Health Care Provider | 2436 Pembroke Ave, Fredericksburg, IA 50630-9499 | 2012-05-21 |
| Find all providers in zip 50630 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1639460009 | Towne Medical, PC | Clinic/Center | 10514 Wakeman Drive, Fredericksburg, VA 22407-8040 | 2011-04-20 |
| 1427355288 | A Larry Boulware Md PC | Clinic/Center | 6330 Five Mile Centre Park Ste 400, Fredericksburg, VA 22407-5516 | 2011-02-14 |
| 1538205521 | Reese Medical Associates | Clinic/Center | 10620 Spotsylvania Ave, Fredericksburg, VA 22408-2637 | 2007-01-29 |
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| 1114568748 | Careatc | Clinic/Center | 3839 Merle Hay Rd Ste 120, Des Moines, IA 50310-1338 | 2019-10-04 |
| 1902269632 | Prairie City Family Clinic | Clinic/Center | 1316 Joshua Ct Se, Bondurant, IA 50035-4700 | 2016-03-31 |
| 1891176285 | Liautaud Family Chiropractic LLC | Clinic/Center | 114 1/2 E Monroe St, Pleasantville, IA 50225-7744 | 2015-06-11 |
| 1669893988 | Winneshiek Medical Center | Clinic/Center | 112 East Main St., Ossian, IA 52101 | 2014-01-06 |
| 1366882300 | Cedar Falls Pediatrics LLC | Clinic/Center | 113 E 18th St, Cedar Falls, IA 50613-4288 | 2013-07-03 |
| 1285996215 | Aguirrefamily Care | Clinic/Center | 1505 Lynx Ave, Webster City, IA 50595-2634 | 2012-06-14 |
| 1770853988 | Huff Chiropractic P.C. | Clinic/Center | 1010 Caroline Ter, Indianola, IA 50125-1009 | 2012-01-04 |
| 1073821427 | Cascade Medical Center | Clinic/Center | 610 2nd Ave Ne, Cascade, IA 52033-7760 | 2010-09-20 |
| 1184931230 | Farid Sadr, P.C. | Clinic/Center | 801 Harmony St Ste 202, Council Bluffs, IA 51503-3106 | 2010-09-10 |
| 1124357991 | George T. Kappos, Md | Clinic/Center | 109 2nd Street, Polk City, IA 50226 | 2009-12-08 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 50630 |
Please comment or provide details below to improve the information on FREDERICKSBURG FAMILY HEALTH CLINIC, PLLC.
| 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.