Active NPI
Benjamin Keith Frederick, M.D.
- Diagnostic Radiology Physician
- Columbia, MO
National Provider Identifier
1982953378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2012026888
- Practice address
- 1 Hospital Dr
Dc069.10
Columbia, MO 65212-1000 - Phone
- (573) 882-7901
- NPI assigned
- Aug 31, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2012026888 | MO | Primary |
Addresses
Primary practice location
1 Hospital Dr
Dc069.10
Columbia, MO 65212-1000
Mailing address
1 Hospital Dr
Dc069.10
Columbia, MO 65212-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346371200000",
"number": "1982953378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR",
"address_2": "DC069.10",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652121000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR",
"address_2": "DC069.10",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652121000",
"telephone_number": "573-882-7901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "BENJAMIN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-31",
"last_updated": "2012-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2012026888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.