Fred Charles Vannatta, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

141442 Issued in NY

Practice address

695 Dutchess Tpke
Suite 105
Poughkeepsie, NY 12603-6442

Phone

(888) 647-5979

Fax

(888) 847-0818

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Borg & Ide Imaging, PC

  • Diagnostic Radiology Physician
  • Rochester, NY
  • NPI 1194714402
  NPD (past)
• Brooklyn Radiology Services PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1699724260
  NPD (past)
• River Radiology PLLC

  • Radiology Clinic/Center
  • Kingston, NY
  • NPI 1912949314

  Diagnostic Radiology

  NPD (past)
• Sound Shore Physician Services

  • Clinic/Center
  • New Rochelle, NY
  • NPI 1689883068
  NPD (past)
• Ulster Radiologic Associates, PC

  • Radiology Clinic/Center
  • Kingston, NY
  • NPI 1326083239
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1891897617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036442",
            "telephone_number": "888-647-5979",
            "fax_number": "845-454-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036442",
            "telephone_number": "888-647-5979",
            "fax_number": "888-847-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "FRED",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "141442",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA07673300",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "31689",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "041448",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A23570",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD041298E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "906S9WQ111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Vanamburgh, COTA
• Alexis Vandecarr, LMSW
• Cindy Belch Vandermark, LCSW
• Manvitha Reddy Vanga, MBBS
• Cristie Vangorden, LPN
• Jo-Ann F Vannorstrand, LPN
• Julia Vantine, MS, LMHC
• Jennifer Vanvoorhees, LPN
• Sankar N Varanasi, MD FACC
• Maria Vargas

• Diagnostic Radiology Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.