Individual provider Active NPI

Christina Marie Frederick

  • Licensed Practical Nurse
  • Ontario, NY
National Provider Identifier
1376866327
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
277497-1 Issued in NY
Practice address
7387 Furnace Rd
Ontario, NY 14519-9723
Phone
(315) 524-2687
NPI assigned
Mar 4, 2010
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 277497-1 NY Primary

Addresses

Primary practice location

7387 Furnace Rd
Ontario, NY 14519-9723

Mailing address

7387 Furnace Rd
Ontario, NY 14519-9723
Phone (315) 524-2687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
277497-1NYMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1376866327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7387 FURNACE RD",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "145199723",
            "telephone_number": "315-524-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7387 FURNACE RD",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "145199723",
            "telephone_number": "315-524-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "277497-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.