NPIMap

Individual provider Active NPI

Dann J Fredrickson, MD

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1215934203
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
114303 Issued in MO
Practice address
5400 N Oak Trfy
Suite 200
Kansas City, MO 64118-4688
Phone
(816) 453-0900
Fax
(816) 453-6271
NPI assigned
Jul 5, 2005
Last updated
Sep 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 114303 MO Primary

Addresses

Primary practice location

5400 N Oak Trfy
Suite 200
Kansas City, MO 64118-4688

Mailing address

5400 N Oak Trfy
Suite 200
Kansas City, MO 64118-4688
Phone (816) 453-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000059 MO Practitioner - Internal Medicine 7214017235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability KCGroup PAC ID 0143116368, 166 clinicians
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

5400 N Oak Trfy
Suite 200
Kansas City, MO 64118-4690
Phone (816) 453-0900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
114303MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation CurrentSince Jul 1, 2011 Accepting new patients
Meritas Health Corporation CurrentSince Jul 1, 2011 Accepting new patients
Meritas Health Corporation Current Accepting new patients

Locations

5400 N Oak Trfy
Ste 200
Kansas City, MO 64118
Phone (816) 453-0900

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1215934203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N OAK TRFY",
            "address_2": "SUITE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184688",
            "telephone_number": "816-453-0900",
            "fax_number": "816-453-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N OAK TRFY",
            "address_2": "SUITE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184688",
            "telephone_number": "816-453-0900",
            "fax_number": "816-453-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "DANN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "114303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.