Individual provider Active NPI

Frederick Durlin Bauschard, M.D.

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1669478558
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R4202 Issued in MO
Practice address
6451 Chippewa St
Ste 2
Saint Louis, MO 63109-2104
Phone
(314) 832-6803
Fax
(314) 832-8072
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X R4202 MO Primary

Addresses

Primary practice location

6451 Chippewa St
Ste 2
Saint Louis, MO 63109-2104

Mailing address

6451 Chippewa St
Ste 2
Saint Louis, MO 63109-2104
Phone (314) 832-6803

Other identifiers 2

IdentifierTypeStateIssuer
0300003OtherMOUNITED HEALTHCARE
17657OtherMOBLUE SHIELD

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

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669478558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "address_2": "STE 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-832-6803",
            "fax_number": "314-832-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "address_2": "STE 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-832-6803",
            "fax_number": "314-832-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSCHARD",
        "first_name": "FREDERICK",
        "middle_name": "DURLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "R4202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0300003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "17657",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.