Individual provider Active NPI

Frederick R Nusbickel, MD

  • Orthopaedic Surgery Physician
  • Thomasville, GA
National Provider Identifier
1447222013
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
GA031805 Issued in GA
Practice address
100 Mimosa Dr
Thomasville, GA 31792-6676
Phone
(229) 226-9141
Fax
(229) 228-0637
NPI assigned
Feb 7, 2006
Last updated
May 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X GA031805 GA Primary

Addresses

Primary practice location

100 Mimosa Dr
Thomasville, GA 31792-6676

Mailing address

PO Box 2968
Thomasville, GA 31799-2968
Phone (229) 226-9141

Other identifiers 4

IdentifierTypeStateIssuer
000398538AMedicaidGA
000398538AOtherGAPEACH STATE
200009782OtherGARAIL ROAD MEDICARE
344368OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000536 GA Practitioner - Orthopedic Surgery 3476558669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA031805GAMDOrthopaedic Surgery Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1447222013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317992968",
            "telephone_number": "229-226-9141",
            "fax_number": "229-228-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926676",
            "telephone_number": "229-226-9141",
            "fax_number": "229-228-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBICKEL",
        "first_name": "FREDERICK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "GA031805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000398538A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE",
            "identifier": "000398538A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "200009782",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "344368",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.