Frederick R Myers, NONE

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

607400911 Issued in NY

Practice address

59 Bradt Hill Rd
Northville, NY 12134-5310

Phone

(518) 921-0976

NPI assigned

Mar 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Fred R Myers Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1922757129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BRADT HILL RD",
            "city": "NORTHVILLE",
            "state": "NY",
            "postal_code": "121345310",
            "telephone_number": "518-921-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 BRADT HILL RD",
            "city": "NORTHVILLE",
            "state": "NY",
            "postal_code": "121345310",
            "telephone_number": "518-921-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "FREDERICK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "NONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "334986825",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "607400911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRED",
            "last_name": "MYERS",
            "middle_name": "R",
            "prefix": "MR.",
            "credential": "NONE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Erin Elizabeth Gurdineer, PSY.D.
• Hanna A Halloran, PT
• Karen Bernice McComb, RPH
• Kristen McComb
• Thomas J Milko, DDS
• Victor Nikolsky, MD
• Northville Central School District
• Joan Victoria Rimkunas, RPH
• Rite Aid of New York Inc
• St. Mary'S Healthcare

• All providers in Northville, NY
• Emergency Medical Services (Emergency Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.