Traditions of Frederic

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0013890 Issued in WI

Legal business name

TRADITIONS OF FREDERIC

Practice address

107 Oak St E
Frederic, WI 54837-9500

Phone

(715) 327-4888

NPI assigned

Feb 18, 2014

Last updated

Jun 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Andrew Mayo, M.D.NPI 1316059660

Title

Owner

Phone

(715) 497-6101

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew G Mayo, M.D.

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1316059660
  Authorized official Same address or phone

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1588089114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OAK ST E",
            "city": "FREDERIC",
            "state": "WI",
            "postal_code": "548379500",
            "telephone_number": "715-327-4889",
            "fax_number": "715-327-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 OAK ST E",
            "city": "FREDERIC",
            "state": "WI",
            "postal_code": "548379500",
            "telephone_number": "715-327-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRADITIONS OF FREDERIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-18",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-497-6101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0013890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Steffen, PTA
• James Tangen-Foster
• Steven Richard Tesch, DDS
• Kristina M Thompson, MSW, LICSW
• Kaci Lee Tolzman, NP
• Jillian Williamson
• Zachary Scott Williamson
• Paula May Zelinski, M.A., CCC-SLP

• Assisted Living Facility in Frederic, WI
• Providers in Frederic, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.