NPIMap

Organization Active NPI

Norfolk Gastroenterology, PC

  • Gastroenterology Physician
  • Norfolk, MA
National Provider Identifier
1306221981
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORFOLK GASTROENTEROLOGY, PC
Practice address
31 Pine St
Suite # 300
Norfolk, MA 02056-1642
Phone
(508) 623-3700
Fax
(508) 623-3701
NPI assigned
Jul 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Dr. Derek Frederickson, MD
Title
President
Phone
(508) 623-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

31 Pine St
Suite # 300
Norfolk, MA 02056-1642

Mailing address

31 Pine St
Suite # 300
Norfolk, MA 02056-1642
Phone (508) 623-3700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1306221981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PINE ST",
            "address_2": "SUITE # 300",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561642",
            "telephone_number": "508-623-3700",
            "fax_number": "508-623-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PINE ST",
            "address_2": "SUITE # 300",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561642",
            "telephone_number": "508-623-3700",
            "fax_number": "508-623-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORFOLK GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "FREDERICKSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-623-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.