GARY W. FREDERICKSEN (NPI# 1629035225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629035225 |
| Entity Type | Individual |
| Full Name | GARY W. FREDERICKSEN |
| Credential | OD |
| Practice Address |
120 Kings Way Suite 1300 Williamsburg VA 23185-2505 |
| Mailing Address |
856 J Clyde Morris Blvd Suite A Newport News VA 23601-1318 |
| Practice Telephone | 7573453001 |
| Practice Fax Number | 7573453102 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2013-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0618000905 | VA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700950557 | Gary J Fredericksen | Counselor | 4422 6th Ave Se, Lacey, WA 98503-1020 | 2006-11-20 |
| Street Address |
120 KINGS WAY SUITE 1300 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23185-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831196872 | Williamsburg Neurology, P.C. | Specialist | 120 Kings Way, Suite 2700, Williamsburg, VA 23185-2505 | 2005-07-06 |
| 1952707002 | Riverside Hospital, Inc | General Acute Care Hospital | 120 Kings Way, Suite 3100a, Williamsburg, VA 23185-2505 | 2014-11-17 |
| 1033452040 | Morlinda M Kruegel | Nurse Practitioner | 120 Kings Way, Suite 3500, Williamsburg, VA 23185-2505 | 2013-03-28 |
| 1609148568 | Riverside Physician Services Inc | Psychiatry & Neurology | 120 Kings Way, Suite 2800, Williamsburg, VA 23185-2505 | 2012-02-07 |
| 1316234081 | Karanvir S. Virk | Obstetrics & Gynecology | 120 Kings Way, Suite 3400, Williamsburg, VA 23185-2505 | 2011-07-01 |
| 1467755132 | Riverside Physician Services Inc | Psychiatry & Neurology | 120 Kings Way, Suite 2800, Williamsburg, VA 23185-2505 | 2010-12-17 |
| 1659692960 | Anthony W. Farah | Ophthalmology | 120 Kings Way, Suite 1300, Williamsburg, VA 23185-2505 | 2010-06-21 |
| 1114255908 | Joann Blair Mello | Nurse Practitioner | 120 Kings Way, Suite 3100, Williamsburg, VA 23185-2505 | 2009-12-07 |
| 1700016805 | Riverside Physician Services, Inc | Orthopaedic Surgery | 120 Kings Way, Ste 3500, Williamsburg, VA 23185-2505 | 2009-07-23 |
| 1588890545 | Krystal E Ainsley | Internal Medicine | 120 Kings Way, Suite 1400, Williamsburg, VA 23185-2505 | 2009-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579412 | Marian Shearin | Technician | 112 Indian Circle, Williamsburg, VA 23185 | 2019-10-09 |
| 1093363251 | 1st Choice In-homecare, Inc. | Durable Medical Equipment & Medical Supplies | 161-a John Jefferson Road Ste 101, Williamsburg, VA 23185 | 2019-08-30 |
| 1265939482 | Michelle Antionette Hill | Counselor | 1769 Jamestown Rd Ste 107, Williamsburg, VA 23185 | 2018-04-13 |
| 1114437480 | Kimberly Anne Allan | Orthotic Fitter | 1811 Jamestown Rd., Williamsburg, VA 23185 | 2017-10-02 |
| 1881115590 | Shawn Patrick Mcnulty | Counselor | Colonial Behavioral Health, 1657 Merrimac Trail, Williamsburg, VA 23185 | 2017-07-03 |
| 1790215986 | Sea Change Therapy Pllc | Community/Behavioral Health | 3308 Ash Vw, Williamsburg, VA 23185 | 2017-06-19 |
| 1316479322 | Maureen Bounds | Pharmacist | 230 Gooch Dr, Williamsburg, VA 23185 | 2017-03-29 |
| 1386196970 | Joshua Desilva | Psychologist | 240 Gooch Drive, 2nd Floor, Williamsburg, VA 23185 | 2016-10-29 |
| 1750837001 | Ellen Lerose | Pharmacist | 5601-b Richmond Road, Williamsburg, VA 23185 | 2016-08-28 |
| 1194173922 | Michael C. Shuck, Dds PC | Dentist | 1480 Quarterpath Rd, Ste 2a, Williamsburg, VA 23185 | 2016-06-02 |
| Find all providers in zip 23185 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013212307 | Washington Eye Care Center LLP | Optometrist | 519 Court Street, Williamsburg, IA 52361-9477 | 2011-01-18 |
| 1548576226 | National Optometry Steven Kasinof and 17 Associates Optometrists | Optometrist | 4655 Monticello Ave, Ste. 201, Williamsburg, VA 23188-8219 | 2010-08-19 |
| 1144459736 | Ryan Lee Striegel | Optometrist | 519 Court St, Williamsburg, IA 52361 | 2009-07-06 |
| 1861656589 | Jeanne I Ruff Od LLC | Optometrist | 5223 Monticello Ave, Suite C, Williamsburg, VA 23188-8236 | 2008-07-11 |
| 1740441450 | Forrest Ronald Schaeffer | Optometrist | 4640 Monticello Ave, Ste 8-a, Williamsburg, VA 23188-8215 | 2008-06-24 |
| 1386769891 | Byron Douglas Karr | Optometrist | 686 S Us 25w, Suite 1, Williamsburg, KY 40769 | 2007-03-21 |
| 1538236880 | Carter L Murphy | Optometrist | 5251 John Tyler Hwy Ste 7, Williamsburg, VA 23185-8808 | 2006-11-30 |
| 1467527770 | 20-20 Eyecare of Virginia Inc | Optometrist | 4640 Monticello Ave Ste 8a, Williamsburg, VA 23188-8230 | 2006-11-21 |
| 1215012679 | Pamela Dawn Lundberg | Optometrist | 101 Bulifants Blvd, Suite A, Williamsburg, VA 23188-5709 | 2006-10-26 |
| 1306950027 | Jeanne Ruff | Optometrist | 4655 Monticello Ave Ste 201c, Williamsburg, VA 23188-8221 | 2006-08-19 |
| Find all providers in WILLIAMSBURG | ||||
| City | WILLIAMSBURG |
| Zip Code | 23185 |
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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.