Active NPI
Patricia Chapman Fredericks, RXN, CNM
- Advanced Practice Midwife
- Fort Collins, CO
National Provider Identifier
1992779235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 64550
- Practice address
- 1106 E Prospect Rd
Fort Collins, CO 80525-5304 - Phone
- (970) 493-7442
- Fax
- (970) 495-7991
- NPI assigned
- Feb 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 64550 | CO | Primary |
Addresses
Primary practice location
1106 E Prospect Rd
Fort Collins, CO 80525-5304
Mailing address
1106 E Prospect Rd
Fort Collins, CO 80525-5304
Phone (970) 493-7442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7026388 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64550 | CO | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | 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 and National Provider Directory roles.
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1992779235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 E PROSPECT RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255304",
"telephone_number": "970-493-7442",
"fax_number": "970-495-7991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 E PROSPECT RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255304",
"telephone_number": "970-493-7442",
"fax_number": "970-495-7991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKS",
"first_name": "PATRICIA",
"middle_name": "CHAPMAN",
"credential": "RXN, CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CO",
"license": "64550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7026388",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.