Matthew Fred, M.S., CRC

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

Practice address

2135 W Ramada LN
Carbondale, IL 62901-5326

Phone

(618) 457-3318

Fax

(618) 549-0132

NPI assigned

Feb 3, 2012

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Southern Illinois Center for Independent Living

  • Case Management Agency
  • Carbondale, IL
  • NPI 1043867112
  NPD (past)
• Southern Illinois Center for Independent Living

  • Voluntary or Charitable Agency
  • Carbondale, IL
  • NPI 1760622682
  NPD (past)

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1346512589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 W RAMADA LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015326",
            "telephone_number": "618-457-3318",
            "fax_number": "618-549-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 W RAMADA LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015326",
            "telephone_number": "618-457-3318",
            "fax_number": "618-549-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRED",
        "first_name": "MATTHEW",
        "credential": "M.S., CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRC",
            "identifier": "00112331",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Jayne Foster, SLP
• Melissa Anne Fowler-Coello
• Nicholas Foy, MSW
• Jeffrey Lee Frakes, M.D.
• Sharmon Elizabeth Frantz-Mahoney, BCBA
• Frederick Gustave, D.D.S., PC
• Shannon Rachelle Freeman Weiss, BCBA
• Marykate Freeman, PSYD
• Nicholas Eugene Freyer
• Daniel Raymond Fulk, D.O.

• Rehabilitation Counselor in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Rehabilitation Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.