Matthew Edward Frericks, ATC, OTC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2556 Issued in MN

Practice address

710 Commerce Dr
Woodbury, MN 55125-4919

Phone

(651) 968-5000

NPI assigned

Aug 15, 2013

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1659704492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5059 CHERRYBARK LN SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559048478",
            "telephone_number": "507-304-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254919",
            "telephone_number": "651-968-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRERICKS",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "ATC, OTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "MN",
            "license": "19-0604",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Freese, DC
• Paige Marie Freese
• Wyatt Freie
• Christopher J French, DDS
• Kari French
• Stephen Lee Fridinger, MD
• Douglas P Friederich, MD
• Fritz Chiropractic, P.a.
• Justin Anthony Fritz, D.C.
• Sandy Jean Fritzlar, MD

• Athletic Trainer in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.