Reginald Augustus Frederick, CST,CSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

SA0076 Issued in DC

Practice address

Carl R. Darnall Army Medical Center
36065 Santa Fe Avenue
Fort Hood, TX 76544-4752

Phone

(254) 618-7508

NPI assigned

May 9, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1255545315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761ST TANK BN. AVE, BLDG.332",
            "address_2": "PO BOX 5865",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765440865",
            "telephone_number": "254-699-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARL R. DARNALL ARMY MEDICAL CENTER",
            "address_2": "36065 SANTA FE AVENUE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765444752",
            "telephone_number": "254-618-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "REGINALD",
        "middle_name": "AUGUSTUS",
        "name_prefix": "Mr.",
        "credential": "CST,CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "DC",
            "license": "SA0076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lane Elise Fraser, DO
• Adam Colby Frazier, DNP, CRNA
• Chantra Cheyenne Frazier, CNM
• Mathew Frazier, PT, DPT
• Kathleen A Frederick, LCSW
• Clifford David Friesen, M. D.
• Peter Frohman, PH.D.
• Ramon E. Fry II, PA
• Sara Fry, MD
• Ibifiri Stella Fubara

• Surgical Assistant in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.