Fredericktown Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FREDERICKTOWN FAMILY PRACTICE

Practice address

16361 Village Pkwy
Fredericktown, OH 43019-9585

Phone

(740) 694-2110

Fax

(740) 694-2127

NPI assigned

Feb 15, 2007

Last updated

Jul 20, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Amanda Bowers

Title

Office Manager

Phone

(740) 694-2110

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1114060472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16361 VILLAGE PKWY",
            "city": "FREDERICKTOWN",
            "state": "OH",
            "postal_code": "430199585",
            "telephone_number": "740-694-2110",
            "fax_number": "740-694-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16361 VILLAGE PKWY",
            "city": "FREDERICKTOWN",
            "state": "OH",
            "postal_code": "430199585",
            "telephone_number": "740-694-2110",
            "fax_number": "740-694-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKTOWN FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-694-2110",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161191",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawn Elliott, STNA
• Jodeen Erfurt, SLP
• Kate Esteph
• Heather Rochelle Evans, RN OCN
• Fredericktown Community Joint Emergency Ambulance District
• Fredericktown Local Schools
• Amber Gantt, STNA
• Tiffanie Getchey, STNA
• Dawn Danielle Giehl, LPN
• Barbara Golden

• Family Medicine Physician in Fredericktown, OH
• Providers in Fredericktown, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.