Active NPI
Tuesday Yvonne Fredricks, RPH
- Pharmacist
- Bradenton, FL
National Provider Identifier
1912459694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS30594
- Practice address
- 1505 26TH Ave E
Bradenton, FL 34208-7707 - Phone
- (941) 713-4577
- Fax
- (941) 708-8517
- NPI assigned
- Oct 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS30594 | FL | Primary |
Addresses
Primary practice location
1505 26TH Ave E
Bradenton, FL 34208-7707
Mailing address
6618 49TH CT E
Ellenton, FL 34222-4037
Phone (813) 376-3299
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS30594 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCR Health, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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": "1477612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1912459694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 49TH CT E",
"city": "ELLENTON",
"state": "FL",
"postal_code": "342224037",
"telephone_number": "813-376-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 26TH AVE E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342087707",
"telephone_number": "941-713-4577",
"fax_number": "941-708-8517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICKS",
"first_name": "TUESDAY",
"middle_name": "YVONNE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-28",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS30594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.