Active NPI
Curtis Carl Fredrickson, MD
- Psychiatry Physician
- Spirit Lake, IA
National Provider Identifier
1548532971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 18252
- Practice address
- 15535 Landings Ave.
Spirit Lake, IA 51360 - Phone
- (952) 412-4192
- NPI assigned
- Feb 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 18252 | IA | Primary |
Addresses
Primary practice location
15535 Landings Ave.
Spirit Lake, IA 51360
Mailing address
15535 Landings Ave.
Spirit Lake, IA 51360
Phone (952) 412-4192
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18252 | IA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1548532971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15535 LANDINGS AVE.",
"city": "SPIRIT LAKE",
"state": "IA",
"postal_code": "51360",
"telephone_number": "952-412-4192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15535 LANDINGS AVE.",
"city": "SPIRIT LAKE",
"state": "IA",
"postal_code": "51360",
"telephone_number": "952-412-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICKSON",
"first_name": "CURTIS",
"middle_name": "CARL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-01",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "18252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spirit Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.