NPIMap

Individual provider Active NPI

Fredrick A Oliver, P.T.

  • Orthopedic Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1740284603
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 09980 Issued in OH
Practice address
4555 Lake Forest Dr
Ste 150
Cincinnati, OH 45242-3781
Phone
(877) 327-2278
Fax
(888) 322-2278
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 09980 OH Primary
Orthopedic Physical Therapist 2251X0800X 005788 KY

Addresses

Primary practice location

4555 Lake Forest Dr
Ste 150
Cincinnati, OH 45242-3781

Mailing address

4555 Lake Forest Dr
Ste 150
Cincinnati, OH 45242-3781
Phone (877) 327-2278

Other identifiers 1

IdentifierTypeStateIssuer
2630442MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
005788KYMDOrthopedic Physical Therapist
PT 09980OHMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Exercise LLC Orthopedic Current Accepting new patients
Rehabilitation Institute of Cincinnati, LLC Past Accepting new patients
Orthopaedic Physical Therapy and Associates Inc. PastSince Jan 1, 2002 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1740284603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 LAKE FOREST DR",
            "address_2": "STE 150",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452423781",
            "telephone_number": "877-327-2278",
            "fax_number": "888-322-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 LAKE FOREST DR",
            "address_2": "STE 150",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452423781",
            "telephone_number": "877-327-2278",
            "fax_number": "888-322-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "FREDRICK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT 09980",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "005788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2630442",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.