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

Organization subpart

No

Name

Edward D Frederickson, MDNPI 1386710085

Title

Ceo

Phone

(706) 212-0390

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2018.

{
    "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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• All providers in Clayton, GA
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• 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.