DR. JON RANDALL FREDERICK (NPI# 1003997800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003997800 |
| Entity Type | Individual |
| Full Name | DR. JON RANDALL FREDERICK |
| Credential | M.D. |
| Practice Address |
8260 Atlee Rd Emergency Dept Mechanicsville VA 23116 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 8047646300 |
| Practice Fax Number | 8047646562 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2018-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 0101242098 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101242098 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | CAQH | 12723963 | 01 |
| Street Address |
8260 ATLEE RD EMERGENCY DEPT |
| City | MECHANICSVILLE |
| State | VA |
| Zip Code | 23116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497749493 | Robert Ingram Sprague | Pathology | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2005-09-06 |
| 1093325144 | Kenley Conley | Clinical Nurse Specialist | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-08-04 |
| 1508480674 | Adrienne Brook Wass | Nurse Anesthetist, Certified Registered | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-06-03 |
| 1962021998 | Kayla Michelle Wiggins | Physician Assistant | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-04-09 |
| 1174159644 | Jamie Lynn Temple | Nurse Practitioner | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-03-17 |
| 1457986903 | Michael Warren Roper | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-03-05 |
| 1316583040 | Hospitalist Medicine Physicians of Virginia - Richmond II, LLC | Internal Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2019-11-18 |
| 1548803976 | Amanda M Vance | Nurse Practitioner | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2019-10-17 |
| 1720639933 | Larissa Laso Rodriguez | Nurse Practitioner | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2019-09-28 |
| 1063078475 | Loree Beth Martin | Nurse Anesthetist, Certified Registered | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2019-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871131664 | Orthovirginia, Inc | Physician Assistant | 9369 Atlee Road Unit 3107, Mechanicsville, VA 23116 | 2019-12-12 |
| 1558915702 | Rachelle Lamaris Smith | Counselor | 7611 Magazine Drive, Mechanicsville, VA 23116 | 2019-07-26 |
| 1467004952 | Katherine Romero-davis | Speech-Language Pathologist | Sheltering Arms Rehabilitation Hospital, 8254 Atlee Road, Mechanicsville, VA 23116 | 2019-07-15 |
| 1275092850 | Melissa Harp Harden | Occupational Therapist | 9366 Count Kristopher Dr, Mechanicsville, VA 23116 | 2019-03-13 |
| 1467969105 | Lynsey Marie Preisner | Physician Assistant | 8262 Atlee Road Suite 202, Mechanicsville, VA 23116 | 2018-01-03 |
| 1912437526 | Kim S Hammonds | Nurse Practitioner | 8102 Braxton Court, Mechanicsville, VA 23116 | 2017-06-15 |
| 1023547528 | Gina Elysia Wurfel | Social Worker | 9126 Ashlar Pl, Mechanicsville, VA 23116 | 2017-06-08 |
| 1063945624 | Lisa Gervasoni | Occupational Therapist | 8254 Attlee Road, Mechanicsville, VA 23116 | 2017-04-10 |
| 1679006308 | Kerri Eggleston | Physical Therapist | 8226 Meadowbridge Road, Mechanicsville, VA 23116 | 2017-04-10 |
| 1659823466 | Mechanicsville Chemist LLC | Pharmacy | 8324 Bell Creek Road, Suite Number 800, Mechanicsville, VA 23116 | 2016-10-27 |
| Find all providers in zip 23116 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639276413 | Daniel Edward Mcgee | Emergency Medicine | 8206 Atlee Rd, Mechanicsville, VA 23116-1844 | 2006-09-20 |
| 1013917186 | Alan L Thurman | Emergency Medicine | 8200 Meadowbridge Rd Ste 301, Mechanicsville, VA 23116-2337 | 2005-07-29 |
| 1457986903 | Michael Warren Roper | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2020-03-05 |
| 1144751215 | Matthew Baltz | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2017-03-21 |
| 1508229964 | Adam Robert Keefer | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2016-04-03 |
| 1003277369 | James River Emergency Group, LLC | Emergency Medicine | 9275 Chamberlayne Rd, Mechanicsville, VA 23116-2800 | 2016-03-15 |
| 1548503766 | Joran Sequeira | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2013-04-05 |
| 1366734626 | Constance See-wei Kwan | Emergency Medicine | 8260 Atlee Rd, Em: Emergency Medicine, Mechanicsville, VA 23116-1844 | 2011-05-05 |
| 1720304603 | Henry Wong | Emergency Medicine | 8260 Atlee Rd, Mechanicsville, VA 23116-1844 | 2010-04-16 |
| 1467688598 | Marie Rodgers Knorr | Emergency Medicine | 8260 Atlee Rd, Emergency Dept, Mechanicsville, VA 23116-1844 | 2009-06-03 |
| Find all providers in MECHANICSVILLE | ||||
| City | MECHANICSVILLE |
| Zip Code | 23116 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.