Shannon Nicole Frederick, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA003232L Issued in PA

Practice address

14 Memorial Dr
Suite a
Doylestown, PA 18901

Phone

(215) 348-2992

Fax

(215) 348-2052

NPI assigned

Jul 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• Doylestown Gynecology, LLC

  • Gynecology Physician
  • Doylestown, PA
  • NPI 1023044609
  Medicare reassignment

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1194987123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 FERRY RD",
            "address_2": "STE 402",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012307",
            "telephone_number": "215-348-2992",
            "fax_number": "215-348-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MEMORIAL DR",
            "address_2": "SUITE A",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "18901",
            "telephone_number": "215-348-2992",
            "fax_number": "215-348-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003232L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foundations Behavioral Health
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• William Peter Frampton, D.O.
• Frank J. Bruno Dmdpc
• Teresa Freeburg
• Freedomlink RX LLC
• Lee Michael Freeman, DPM
• Rachel Friel
• Donald G Frost, RPH

• Medical Physician Assistant in Doylestown, PA
• Providers in Doylestown, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.