John J Frederick, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

5101007568 Issued in MI

Practice address

3346 Lennon Rd
Suite 2
Flint, MI 48507-1082

Phone

(810) 732-1919

Fax

(810) 732-3740

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Mdo Imaging Associates PLC

  • Diagnostic Radiology Physician
  • Flint, MI
  • NPI 1386684892
  NPD (past)
• United Diagnostics PLLC

  • Diagnostic Radiology Physician
  • Rochester Hills, MI
  • NPI 1003160755
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1265469332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 LENNON ROAD",
            "address_2": "SUITE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071015",
            "telephone_number": "810-732-1919",
            "fax_number": "810-732-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3346 LENNON RD",
            "address_2": "SUITE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071082",
            "telephone_number": "810-732-1919",
            "fax_number": "810-732-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101007568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "310B510660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300075605",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3321207",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Rose Frazier
• Tracy Marie Frazier
• Frederick C Schreiber DO PC
• Frederick R. Armenti, M.D., P.C.
• Elizabeth Rosemary Frederick, LLP
• Jeremy Fredrich
• Katherine Jean Freds, LMSW
• Freedom Fields Senior Community
• Melinda Freeland, LMSW
• Alyssa Marie Freeman

• Diagnostic Radiology Physician in Flint, MI
• Providers in Flint, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.