Amber D Fredrickson, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2625 N 19TH St
Bismarck, ND 58503

Phone

(701) 222-3175

Fax

(701) 222-3186

NPI assigned

Mar 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amber D Brandenburger Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Red Door Pediatric Therapy, Inc

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1639257033

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1205252749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "AMBER",
        "middle_name": "D",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60460450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "BRANDENBURGER",
            "middle_name": "D",
            "credential": "DPT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sally Gean Frank, NP-C
• Shantell Frank
• Walter E Frank, MD
• Angela Franklund
• Beverly Nicole Franz
• Ward Fredrickson
• Freds Eden Park Caring Homes LLC
• Freds Transportation Caring LLC
• Heather A Freitag, CRNA
• Todd David Freitag

• Physical Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.