Frederick William Born, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

510 100 9712 Issued in MI

Practice address

4077 S Cleveland Ave
Saint Joseph, MI 49085-9513

Phone

(269) 429-2992

Fax

(269) 429-3372

NPI assigned

Jul 27, 2005

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)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Frederick W. Born

  • Family Medicine Physician
  • Saint Joseph, MI
  • NPI 1306233242
  NPD (past) Authorized official

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1295735751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 S CLEVELAND AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859513",
            "telephone_number": "269-429-2992",
            "fax_number": "269-429-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 S CLEVELAND AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859513",
            "telephone_number": "269-429-2992",
            "fax_number": "269-429-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORN",
        "first_name": "FREDERICK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "510 100 9712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Ryan Boehm, DO
• Stuart William Boekeloo, D.D.S.
• Jay Richard Bond
• Blanka Bono
• Eva M Borcherding, LMT
• Daniel Davis Bosis Jr., M.D.
• Rebekah Elisabeth-Carradine Boulanger
• James Daniel Bozyk II, PA
• Michelle E Branch, CMA
• Daniel W Brash, M.D.

• Family Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.