Fred Anthony Zappa III

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6695 Clearwater Creek Dr
Lino Lakes, MN 55038-7705

Phone

(651) 895-4133

NPI assigned

Nov 4, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1588037121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6695 CLEARWATER CREEK DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550387705",
            "telephone_number": "651-895-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6695 CLEARWATER CREEK DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550387705",
            "telephone_number": "651-895-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAPPA",
        "first_name": "FRED",
        "middle_name": "ANTHONY",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charyl Renee Weingarten, DDS
• Kaylen Whetstone, CCC-SLP
• Katia J Wilcox
• Loren Max Wilkes, MD
• Sarah Elizabeth Williams, M.A. CCC-SLP
• Kelsi Zellinger, PT
• Julie G Zimmerman, MD

• Student in an Organized Health Care Education/Training Program in Lino Lakes, MN
• Providers in Lino Lakes, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.