DR. FREDRICK J. ASTLE (NPI# 1750575338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750575338 |
| Entity Type | Individual |
| Full Name | DR. FREDRICK J. ASTLE |
| Credential | PHD, APRN, PMHCNS-BC |
| Practice Address |
2638 Two Notch Road Suite 110 Columbia SC 29204 |
| Mailing Address |
Po Box 5731 College of Nursing Columbia SC 29250-5731 |
| Practice Telephone | 8032562500 |
| Practice Fax Number | 8037581726 |
| Mailing Telephone | 8032562500 |
| Mailing Fax Number | 8037581726 |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2011-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
4291 | SC | Nursing Service Providers |
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R38298 | SC | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PTAN | AA72856580 | 01 |
| Street Address |
2638 TWO NOTCH ROAD SUITE 110 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578185369 | Marion Johnson | Registered Nurse | 9633 Clocktower Ln, Columbia, MD 21046-1877 | 2020-05-14 |
| 1073167185 | Shyeasha Wilson | Registered Nurse | 1460 Oakcrest Dr Apt 2120, Columbia, SC 29223-1746 | 2019-07-26 |
| 1689122640 | Chanelle M Johnson | Registered Nurse | 217 Gateway Ln, Columbia, SC 29210-7452 | 2016-09-19 |
| 1871980763 | Bertha Ansley | Registered Nurse | 10775 Bridlerein Ter, Columbia, MD 21044-3650 | 2015-04-19 |
| 1356631022 | Henretta Nesbitt Milton | Registered Nurse | 105 Saddleridge Rd, Columbia, SC 29223-4245 | 2011-04-14 |
| 1427378157 | Nekesha Lashae Archie | Registered Nurse | 2020 Hampton St, 3rd Floor, Columbia, SC 29204-1002 | 2010-06-04 |
| 1942330014 | Jason Matthew Tallman | Registered Nurse | 109 Kensington Pl, Columbia, TN 38401-8885 | 2007-03-06 |
| 1093878191 | Larry Randolph Jackson | Registered Nurse | 615 Rapids Rd, Columbia, SC 29212-3024 | 2006-12-19 |
| 1477629582 | Nancy Ragan Canaday | Registered Nurse | 2715 Colonial Drive, Columbia, SC 29203 | 2006-11-28 |
| 1720037872 | Priscilla L. Addison | Registered Nurse | 2715 Colonial Dr, Camhc, Columbia, SC 29203-6818 | 2006-05-08 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on DR. FREDRICK J. ASTLE.
| 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.