Shelby Q Frederick, LMT, RP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

10503 Blacklick Eastern Rd # 12
Pickerington, OH 43147-7872

Phone

(614) 288-9251

Fax

(614) 604-8967

NPI assigned

May 5, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1154555266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 FENWAY CIR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688255",
            "telephone_number": "614-288-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10503 BLACKLICK EASTERN RD # 12",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477872",
            "telephone_number": "614-288-9251",
            "fax_number": "614-604-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "SHELBY",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "LMT, RP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.017113",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Pickerington, OH
• Providers in Pickerington, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.

Verify at the official NPI Registry.