J Brian Frederick, M.D., PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

39332 Issued in KY

Legal business name

J BRIAN FREDERICK, M.D., PLLC

Practice address

617 23Rd St Ste 415
Ashland, KY 41101-2845

Phone

(606) 325-6888

Fax

(606) 326-9368

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

James Brian Frederick

Title

President

Phone

(606) 325-6888

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1437356532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 415",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-325-6888",
            "fax_number": "606-326-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 415",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012845",
            "telephone_number": "606-325-6888",
            "fax_number": "606-326-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J BRIAN FREDERICK, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-325-6888"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "39332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64103179",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy E Ison, PHARMD
• Brittany Layne Ison, IECE, BA. GEN STUDY
• Lisa Ison, RN
• Dallas Ivey
• Sriram K Iyer, MD
• J. Timothy Garner, MD, PLLC
• Jack F. Ditty, MD, PSC
• Melissa Cheri Jacobs, LPCC
• Anshu K Jain, M.D.
• Asheesh Jain, MBBS

• Specialist in Ashland, KY
• Providers in Ashland, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.