Marilynn E Frederiksen, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

68138 Issued in WI

Practice address

945 N 12TH St
Milwaukee, WI 53233-1305

Phone

(414) 219-7956

NPI assigned

Jul 21, 2005

Last updated

Sep 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1811996796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "MARILYNN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WI",
            "license": "68138",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "36058725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD NO",
            "identifier": "1627904",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071887",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Frazier, PA-C
• Lawrence Jeffrey Frazin, M.D.
• Vanessa Freberg
• Kerry B Frederick, SLP
• Abby Nicole Frederickson, DO
• Kaitlyn G Fredrich, PA-C
• Latifah Free
• Julie Freed, M.D. PHD
• Freedom Home Health Care, LLC
• Dean Freeland, PT

• Maternal & Fetal Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Maternal & Fetal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.