Individual provider Active NPI

Trudy E Frederics, AUD

  • Audiologist
  • Denver, CO
National Provider Identifier
1902826795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD-175 Issued in CO
Practice address
777 Bannock St
MC 7782
Denver, CO 80204-4507
Phone
(303) 436-6000
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD-175 CO Primary

Addresses

Primary practice location

777 Bannock St
MC 7782
Denver, CO 80204-4507

Mailing address

777 Bannock St
MC 7782
Denver, CO 80204-4507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060921000566 CO Practitioner - Qualified Audiologist 8123023348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD-175COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Aug 5, 2016 Accepting new patients
Denver Health and Hospital Authority CurrentSince Aug 5, 2016 Accepting new patients

Locations

777 Bannock St
#7782
Denver, CO 80204
Phone (720) 956-2394

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902826795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "address_2": "MC 7782",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "address_2": "MC 7782",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICS",
        "first_name": "TRUDY",
        "middle_name": "E",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "AUD-175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.