Active NPI
John Eric Fredmonsky
- Pediatric Physical Therapist
- North Royalton, OH
National Provider Identifier
1477973949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 04085
- Practice address
- 3403 Valley Pkwy
North Royalton, OH 44133-5303 - Phone
- (440) 821-5193
- NPI assigned
- Apr 23, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 04085 | OH | Primary |
Addresses
Primary practice location
3403 Valley Pkwy
North Royalton, OH 44133-5303
Mailing address
3403 Valley Pkwy
North Royalton, OH 44133-5303
Phone (440) 821-5193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04085 | Other | OH | PHYSICAL THERAPIST |
Other names 1
- Mr. John Eric Fredmonsky
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04085 | OH | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398297600000",
"number": "1477973949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3403 VALLEY PKWY",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441335303",
"telephone_number": "440-821-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3403 VALLEY PKWY",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441335303",
"telephone_number": "440-821-5193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDMONSKY",
"first_name": "JOHN",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-23",
"last_updated": "2014-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OH",
"license": "04085",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST",
"identifier": "04085",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOHN",
"last_name": "FREDMONSKY",
"middle_name": "ERIC",
"prefix": "MR.",
"credential": "PHYSICAL THERAPIST",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in North Royalton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.