Ryan M Frederick, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1509105 Issued in AR

Practice address

515 Enterprise Dr 300
Lowell, AR 72745-8982

Phone

(479) 717-7626

Fax

(479) 717-7627

NPI assigned

Jul 31, 2007

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rfrederick716474@directc.mercy.net

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment Care Compare group NPD
• Mercy Health Northwest Arkansas Communities

  • Orthopaedic Surgery Physician
  • Rogers, AR
  • NPI 1063835908
  NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1902096498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 ENTERPRISE DR 300",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727458982",
            "telephone_number": "479-717-7626",
            "fax_number": "479-717-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 ENTERPRISE DR 300",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727458982",
            "telephone_number": "479-717-7626",
            "fax_number": "479-717-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1509105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Dwain Ford
• David B. Fort Jr., M.D.
• Robin Lianne Forward-Wise, M.D.
• Nerissa S France
• Michael Antoni Franklin, MS,CF-SLP
• Friendship Community Care
• Marcia Lynn Fuller, M.S.
• Cheryl A Fulton, DO
• Caleb O Gaston, M.D.
• Anne Godby, MS, CCC-SLP

• Professional Counselor in Lowell, AR
• Providers in Lowell, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.