Gary A. Frederick, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15799 Issued in OK

Practice address

905 S Main St
Shattuck, OK 73858-9205

Phone

(580) 938-2551

Fax

(580) 938-2118

NPI assigned

Jul 12, 2005

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Louisiana State University School of Medicine in New Orleans, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hemphill County Hospital DistrictGroup PAC ID 4587652078, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEDDBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hemphill County Hospital District

  dba Canadian Family Physicians

  • Rural Health Clinic/Center
  • Canadian, TX
  • NPI 1720404924
  Medicare reassignment Care Compare group
• Newman Physicians' Group, Inc.

  • Family Medicine Physician
  • Shattuck, OK
  • NPI 1316054232
  NPD
• Hemphill County Hospital District

  dba Hemphill County Hospital Provider Group

  • Critical Access Hospital
  • Canadian, TX
  • NPI 1578436671
  NPD
• Cancer Center of Kansas, P.a.

  • Hematology & Oncology Physician
  • Wichita, KS
  • NPI 1841251394
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1194723213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-2551",
            "fax_number": "580-938-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-2551",
            "fax_number": "580-938-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "GARY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "15799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100652050B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorrie Corbin
• John Rodney Cully, DPH
• Ellis County EMS
• Michael W. Flaherty, MD
• Foundation Health & Wellness Institute PC
• HCC of Shattuck, LLC
• John David Herber, R.PH., D.PH.
• Jennifer Hix
• Kristen a Burris, D.D.S. L.L.C.
• Gary Willis Mitchell, D.PH.

• Family Medicine Physician in Shattuck, OK
• Providers in Shattuck, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.