Denise B. Fredericks, PT, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1623 Issued in SC

Legal business name

DENISE B. FREDERICKS, PT, LLC

Practice address

1636 Oak Island Dr
Charleston, SC 29412-9519

Phone

(843) 762-6793

Fax

(843) 762-1154

NPI assigned

Mar 17, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Bundrick Fredericks, PTNPI 1902052178

Title

Physical Therapist

Phone

(843) 906-5210

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise B. Fredericks, P.T.

  • Physical Therapist
  • Charleston, SC
  • NPI 1902052178
  NPD (past) Authorized official

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407825706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 OAK ISLAND DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129519",
            "telephone_number": "843-762-6793",
            "fax_number": "843-762-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 OAK ISLAND DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129519",
            "telephone_number": "843-762-6793",
            "fax_number": "843-762-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENISE B. FREDERICKS, PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREDERICKS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "BUNDRICK",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "843-906-5210",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH0142",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Denesia, MD
• Emily Grace Deng, OD
• Michael Waitus Denham, MD, MS, MPHIL
• Sarah Lynn Denham, NP
• Carol A Denier, PH.D.
• Chloe Denman
• Paige Elizabeth Denney, PMHNP
• Riley Cathrine Denning
• Dennis J Fisher, M.D., P.a.
• Ashly Dennis

• Physical Therapist in Charleston, SC
• Providers in Charleston, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.