John E Fredell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24059 Issued in MN

Practice address

40520 County Highway 34
Ogema, MN 56569-9612

Phone

(218) 983-4300

Fax

(218) 983-6394

NPI assigned

Jun 14, 2006

Last updated

Feb 1, 2012By 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

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1962445171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDELL",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "24059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0106863",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "10065",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18686",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP19497",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "01603FR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0106061",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE #",
            "identifier": "DA9041015692",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS/BANNERHEALTH #",
            "identifier": "MN100038",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0106058",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE #",
            "identifier": "125910",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO/ARAZ #",
            "identifier": "900856",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet K Enger, AUDIOLOGIST
• Taylor Erickson, PHARMD
• Sara A Erie, MS NCC LPCC
• Samuel Loren Foster, RPH
• Shelly M Foster IV
• Gail J Gardner, RD LD CDE
• Philip Thomas Gorz, PHARM D.
• Abdelmadjid Guerrah, M.D.
• Debra Elaine Hall, APRN
• Joanne I Hanson, RT

• Family Medicine Physician in Ogema, MN
• Providers in Ogema, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.