Active NPI
Megan N Fredrick
- Physical Medicine & Rehabilitation Physician
- West Carrollton, OH
National Provider Identifier
1073331823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 11608
- Practice address
- 115 Elmwood Cir
West Carrollton, OH 45449-2428 - Phone
- (937) 886-3814
- NPI assigned
- Oct 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 11608 | OH | Primary |
Addresses
Primary practice location
115 Elmwood Cir
West Carrollton, OH 45449-2428
Mailing address
1167 Shannon LN
Xenia, OH 45385-2789
Phone (937) 510-1536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11608 | OH | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1073331823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1167 SHANNON LN",
"city": "XENIA",
"state": "OH",
"postal_code": "453852789",
"telephone_number": "937-510-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 ELMWOOD CIR",
"city": "WEST CARROLLTON",
"state": "OH",
"postal_code": "454492428",
"telephone_number": "937-886-3814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICK",
"first_name": "MEGAN",
"middle_name": "N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-01",
"last_updated": "2024-10-01",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OH",
"license": "11608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Carrollton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.