Edward Dent Frederickson, MD
Individual provider Active NPI Internal Medicine Physician · Clayton, GA
NPI 1386710085 · NPPES record last updated Jul 29, 2019
Key facts
- NPI
- 1386710085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 032384 (GA)
- Practice address
- 156 N Main St
Clayton, GA 30525-4266 - Phone
- (706) 212-0390
- Fax
- (706) 960-9209
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Emory University School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
156 N Main St
Clayton, GA 30525-4266
Phone (706) 212-0390
Hospital & facility affiliations
- Tugaloo Home Health Agency, an Amedisys Company
- Northeast Georgia Home Health III, LLC
- Enhabit Home Health
- Mountain Lakes Medical Center
- Northeast Georgia Medical Center Habersham
- Northeast Georgia Medical Center, Inc
- Highlands Cashiers Hospital
- Northside Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.32 of 100
- Quality
- 90.64
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120203000433 | GA | Practitioner - Internal Medicine |
9830136100 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032384 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David C. Lowance, MD,PC | Internal Medicine | Current | Accepting new patients |
| Mountain Medical Specilities Inc | Internal Medicine | Current |
Accepting new patients |
| Piedmont Nephrology and Internal Medicine, LLC | Nephrology | Current | Accepting new patients |
| Highlands Internal Medicine, PC | Internal Medicine | Current |
Accepting new patients |
Locations
35 Collier Rd NW
#610
Atlanta, GA 30309
35 Collier Rd NW
Ste 610
Atlanta, GA 30309
Phone (404) 355-2024
156 N Main St
Clayton, GA 30525
Phone (706) 212-0390
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EGIGBD
- https://fhir4.healow.com/fhir/r4/EGIGBD/Endpoint/EGIGBD
- edward.frederickson@him2.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 032384 | GA | |
| Internal Medicine Physician | 207R00000X | 032384 | GA | Yes |
Addresses
Primary practice location
156 N Main St
Clayton, GA 30525-4266
Mailing address
156 N Main St
Clayton, GA 30525-4266
Phone (706) 212-0390
Other providers in Clayton, GA
- Family Art Therapy Center PC
- Julie Ann Farrow
- Lisa M Ferraro
- Foothills Emergency Services, LLC
- Karen J Frank
- Suzanne A Frederickson
- Louis Peter Fuerstman
- Fundamental Therapy Services, LLC
- Wesley Turner Funk
- Gainesville Physical Therapy-Clayton
All providers in Clayton, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.