Fedrick Group, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

FEDRICK GROUP, LLC

Doing business as

The Athlete's Foot

Practice address

875 Lawrenceville Suwanee Rd
Suite 310
Lawrenceville, GA 30043-8479

Phone

(678) 377-2788

Fax

(678) 377-2788

NPI assigned

Dec 11, 2008

Last updated

Dec 11, 2008By 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

Mrs. Kasinda Fedrick

Title

Partner

Phone

(678) 377-2788

Specialties & licenses 1

Addresses

Other names 1

• The Athlete's Foot Doing business as

Locations

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1205071867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 LAWRENCEVILLE SUWANEE RD",
            "address_2": "SUITE 310",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438479",
            "telephone_number": "678-377-2788",
            "fax_number": "678-377-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 LAWRENCEVILLE SUWANEE RD",
            "address_2": "SUITE 310",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438479",
            "telephone_number": "678-377-2788",
            "fax_number": "678-377-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDRICK GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "FEDRICK",
        "authorized_official_first_name": "KASINDA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "678-377-2788",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Athlete's Foot",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kalli Kole Faulkner, D.O.
• Pablo David Faundez, LAPC
• Kasheen Fasha Faustin, AUD
• Favors Behavioral Health & Consulting Services, LLC
• Lauren Fedigan
• Arnaud Felix, MD
• Martin Ephrem Felix Jr., MD
• Melinda Felt, MSW
• Laurie Marie Felten Nuchurch, D.C.
• Tasha Elizabeth Felton Williams, WHCNP

• Prosthetic/Orthotic Supplier in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.