Highlands Internal Medicine, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HIGHLANDS INTERNAL MEDICINE, PC

Practice address

156 North Main St
Clayton, GA 30525-4266

Phone

(706) 212-0390

Fax

(706) 960-9209

NPI assigned

Aug 1, 2018

Last updated

Aug 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward D Frederickson, MDNPI 1386710085

Title

Ceo

Phone

(706) 212-0390

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EGIGBD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Dent Frederickson, MD

  • Internal Medicine Physician
  • Clayton, GA
  • NPI 1386710085
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1346728375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 NORTH MAIN ST",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254266",
            "telephone_number": "706-212-0390",
            "fax_number": "706-960-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 NORTH MAIN ST",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254266",
            "telephone_number": "706-212-0390",
            "fax_number": "706-960-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLANDS INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "FREDERICKSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-212-0390",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clayton, GA
• Providers in Clayton, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.