DR. DAVID LEE FREDERICKSON (NPI# 1881660306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881660306 |
| Entity Type | Individual |
| Full Name | DR. DAVID LEE FREDERICKSON |
| Credential | MD |
| Practice Address |
1406 6th Ave N St Cloud MN 56303-1901 |
| Mailing Address |
1406 6th Ave N Saint Cloud MN 56303-1900 |
| Practice Telephone | 3202555657 |
| Mailing Telephone | 3202555657 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 18159 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
1406 6TH AVE N |
| City | ST CLOUD |
| State | MN |
| Zip Code | 56303-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588743561 | Michael S Currie | Nurse Anesthetist, Certified Registered | 1406 6th Ave N, St Cloud, MN 56303 | 2006-11-02 |
| 1639285596 | Masahiko Sato | Marriage & Family Therapist | 1406 6th Ave N, St Cloud Hospital - Recovery Plus, St Cloud, MN 56303 | 2006-08-22 |
| 1245267566 | Gregory A Schlosser | Physical Medicine & Rehabilitation | 1406 6th Ave N, St Cloud, MN 56303-1900 | 2006-06-26 |
| 1992755052 | Jon C Bowar | Psychiatry & Neurology | 1406 6th Ave N, St Cloud, MN 56303 | 2006-05-11 |
| 1720038714 | Mark Irvin Holub | Psychiatry & Neurology | 1406 6th Ave N, St Cloud, MN 56303 | 2006-05-11 |
| 1699724104 | Cynthia A Sandberg | Nurse Practitioner | 1406 6th Ave N, St Cloud, MN 56303 | 2006-05-10 |
| 1245206291 | Debra S Lalley | Registered Nurse | 1406 6th Ave N, St Cloud Hospital Behavioral Health Clinic, St Cloud, MN 56303 | 2006-02-28 |
| 1770559148 | Mark Elmer Hoffmann | Emergency Medicine | 1406 6th Ave N, St Cloud Hospital Emergency Trauma Center, St Cloud, MN 56301 | 2006-02-27 |
| 1346216512 | Renee Linda Funk | Physician Assistant | 1406 6th Ave N, St Cloud, MN 56303-1901 | 2006-02-27 |
| 1831165604 | Jeffrey Carl Windschitl | Emergency Medicine | 1406 6th Ave N, St Cloud, MN 56303-1901 | 2006-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346217874 | John E Mertz | Emergency Medicine | 1406 6 Ave N, St Cloud, MN 56301-1901 | 2006-03-03 |
| 1770559148 | Mark Elmer Hoffmann | Emergency Medicine | 1406 6th Ave N, St Cloud Hospital Emergency Trauma Center, St Cloud, MN 56301 | 2006-02-27 |
| 1710953393 | Brett Thomas Stolzenberg | Emergency Medicine | 1406 6th Ave No, St Cloud, MN 56303-1901 | 2006-02-24 |
| 1831165604 | Jeffrey Carl Windschitl | Emergency Medicine | 1406 6th Ave N, St Cloud, MN 56303-1901 | 2006-02-23 |
| 1477528057 | Michael James Severson | Emergency Medicine | 1406 Sixth Ave N, St Cloud, MN 56301 | 2006-02-17 |
| 1174598825 | Stephen John Jameson | Emergency Medicine | 1406 6th Ave N, St Cloud, MN 56303 | 2006-02-17 |
| 1235104993 | Peter L Charvat | Emergency Medicine | 1406 6th Ave N, St Cloud Hospital, St Cloud, MN 56303 | 2006-02-17 |
| 1164497830 | Joseph Justis Randolph | Emergency Medicine | 1406 6th Ave N, St Cloud, MN 56303-1901 | 2006-02-17 |
| 1326011933 | Anthony P Haas | Emergency Medicine | 1406 6th Ave N, St Cloud Hospital, St Cloud, MN 56303 | 2006-02-13 |
| 1144293945 | Daniel Lloyd Fark | Emergency Medicine | 1406 6th Ave N, St Cloud, MN 56303-1901 | 2006-02-10 |
| Find all providers in ST CLOUD | ||||
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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.