Robert M Frederickson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14145 Issued in AL

Practice address

513 Brookwood Blvd
Suite 50
Birmingham, AL 35209-6862

Phone

(205) 877-2761

Fax

(205) 877-2399

NPI assigned

Aug 30, 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 5

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Alabama School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Champion Sports Medicine Birmingham, LLCGroup PAC ID 4880082429, 180 clinicians

Brookwood Internists PCGroup PAC ID 6406875418, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.frederickson@brookwoodinternists.directbygreenway.com

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.

• Brookwood Internists PC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1316056328
  Medicare reassignment Care Compare group NPD
• Champion Sports Medicine Birmingham, LLC.

  • Physical Therapy Clinic/Center
  • Gardendale, AL
  • NPI 1346813516
  Care Compare group

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1306955497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BROOKWOOD BLVD",
            "address_2": "SUITE 50",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096862",
            "telephone_number": "205-877-2761",
            "fax_number": "205-877-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BROOKWOOD BLVD",
            "address_2": "SUITE 50",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096862",
            "telephone_number": "205-877-2761",
            "fax_number": "205-877-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "14145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51503327",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110224928",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "631266801 0041",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9960800",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "E46611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Frazier, LICSW PIP
• Dalton Frederick
• Jeremy Samuel Frederick, MD
• John William Frederick, M.D.
• Thomas Fredericks, DO
• Freds Stores of Tennessee Inc
• Freds Stores of Tennessee Inc
• Hunter Edward Freed
• David Freedman
• Freedom Source Inc

• Internal Medicine Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.