Active NPI
Christina Frederick
- Registered Nurse
- Malone, NY
National Provider Identifier
1962854422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 674341
- Practice address
- 355 W Main St Ste 425
Malone, NY 12953-1826 - Phone
- (518) 481-1529
- NPI assigned
- Jul 8, 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 674341 | NY | Primary |
Addresses
Primary practice location
355 W Main St Ste 425
Malone, NY 12953-1826
Mailing address
8425 US Highway 11
Potsdam, NY 13676-3235
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 674341 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467936000000",
"number": "1962854422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8425 US HIGHWAY 11",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136763235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W MAIN ST STE 425",
"city": "MALONE",
"state": "NY",
"postal_code": "129531826",
"telephone_number": "518-481-1529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "CHRISTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-08",
"last_updated": "2016-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "674341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.