AMIE FREDERICK (NPI# 1629452156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629452156 |
| Entity Type | Individual |
| Full Name | AMIE FREDERICK |
| Credential | PA-C |
| Practice Address |
305 Flanders Rd East Lyme CT 06333 |
| Mailing Address |
305 Flanders Rd East Lyme CT 06333-1743 |
| Practice Telephone | 8607390348 |
| Practice Fax Number | 8607396779 |
| Mailing Telephone | 8607390348 |
| Mailing Fax Number | 8607396779 |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2018-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 003828 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 0110-005632 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 0004295 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1080 First Colonial Rd, Suite 412, Virginia Beach, VA 234542406 | 7573956500 |
| Street Address |
305 FLANDERS RD |
| City | EAST LYME |
| State | CT |
| Zip Code | 06333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720047285 | Kathryn M Cambi | Pediatrics | 305 Flanders Rd, Flanders Pediatrics, LLC, East Lyme, CT 06333-1743 | 2006-03-22 |
| 1356775332 | Renee Ann Brown | Chiropractor | 305 Flanders Rd, Suite 6, East Lyme, CT 06333 | 2013-08-27 |
| 1932445681 | Genesys Diagnostics, Inc. | Clinical Medical Laboratory | 305 Flanders Rd, East Lyme, CT 06333-1743 | 2012-12-28 |
| 1073826533 | Tianne A Pape | Chiropractor | 305 Flanders Rd, Suite #6, East Lyme, CT 06333-1743 | 2010-07-26 |
| 1134455520 | Elizabeth Henry | Nurse Practitioner | 305 Flanders Rd, East Lyme, CT 06333-1743 | 2009-10-20 |
| 1982767786 | Grace K. Grajales | Nurse Practitioner | 305 Flanders Rd, East Lyme, CT 06333-1743 | 2006-12-19 |
| 1457366742 | Brenda B Mcneil | Nurse Practitioner | 305 Flanders Rd, Flanders Pediatrics, East Lyme, CT 06333-1743 | 2006-07-29 |
| 1568402006 | Maria A Lopez | Pediatrics | 305 Flanders Rd, East Lyme, CT 06333-1743 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720575541 | Alaina Anne King | Counselor | 315 Flanders Rd Ste A, East Lyme, CT 06333 | 2018-04-17 |
| 1477861391 | Hong Qi | Acupuncturist | 26 Sandpiper Lane, East Lyme, CT 06333 | 2010-09-14 |
| 1124164777 | Maureen Lynn Spitzer | Psychiatry & Neurology | 15 Chesterfield Road, Suite 212, East Lyme, CT 06333 | 2007-01-30 |
| 1265599278 | Joseph Anthony Palumbo | Dentist | 15 Church Lane, East Lyme, CT 06333 | 2007-01-02 |
| 1942361654 | Debra Kaufman Daren | Dentist | 131 Boston Post Rd., East Lyme, CT 06333 | 2006-12-13 |
| 1164534384 | Kim Shepardson Watson | Social Worker | 29 Chesterfield Rd, East Lyme, CT 06333 | 2006-09-01 |
| 1033125323 | James Anthony Dyer | Dentist | 131 Boston Post Road, East Lyme, CT 06333 | 2006-07-31 |
| 1467484337 | Stop and Shop Supermarket Co LLC | Pharmacy | 248 Flanders Road, East Lyme, CT 06333 | 2006-07-07 |
| 1902849839 | Carol A Thompson | Marriage & Family Therapist | 29 Chesterfield Road, East Lyme, CT 06333 | 2006-06-14 |
| 1326460031 | Chiro2go LLC | Chiropractor | 183 Boston Post Rd, East Lyme, CT 06333 | 2014-01-15 |
| Find all providers in zip 06333 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235112418 | B Geoffrey Burnham | Physician Assistant | 324 Flanders Rd, East Lyme, CT 06333-1735 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295913 | Courtney Marquardt | Physician Assistant | 25 Buckland Rd, South Windsor, CT 06074-3703 | 2020-11-04 |
| 1154922623 | Alexis Cardinali | Physician Assistant | 175 S Meriden Rd, Cheshire, CT 06410-2973 | 2020-11-02 |
| 1689274417 | Danielle Kerr | Physician Assistant | 1055 Kennedy Rd, Windsor, CT 06095-1308 | 2020-10-30 |
| 1467051920 | Cynthia G Moreno | Physician Assistant | 76 Newtown Rd Ste C, Danbury, CT 06810-6265 | 2020-10-25 |
| 1245837764 | Lauren Tripodi | Physician Assistant | 9 Sunset Hill Rd, Newtown, CT 06470-1318 | 2020-10-07 |
| 1710594403 | Mary Josephine Elliott | Physician Assistant | 50 Beechwood Dr, Madison, CT 06443-1847 | 2020-09-26 |
| 1558977868 | Gabrielle Guetta | Physician Assistant | 25 Woody Ln, Westport, CT 06880-2260 | 2020-09-22 |
| 1609481639 | Gresi Kello | Physician Assistant | 506 Frost Rd, Waterbury, CT 06705-2304 | 2020-09-15 |
| 1477167351 | Connecticut Children's Eye Care, P.C. | Physician Assistant | 131 New London Tpke Ste 200, Glastonbury, CT 06033-2246 | 2020-09-08 |
| 1750991303 | Lana Chapman | Physician Assistant | 289 Curtis St Apt 2, Meriden, CT 06450-5910 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
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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.