DR. NEIL WILLIAM FREDERICKSON (NPI# 1245385327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245385327 |
| Entity Type | Individual |
| Full Name | DR. NEIL WILLIAM FREDERICKSON |
| Credential | M.D. |
| Practice Address |
1035 Bellevue Ave 407 Saint Louis MO 63117-1854 |
| Mailing Address |
1035 Bellevue Ave 204 Saint Louis MO 63117-1854 |
| Practice Telephone | 3146451344 |
| Practice Fax Number | 3146456457 |
| Mailing Telephone | 3146451344 |
| Mailing Fax Number | 3146456457 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2016-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
R8D71 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1035 BELLEVUE AVE 407 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396738019 | William B Guyol Jr. | Internal Medicine | 1035 Bellevue Ave, Suite 105, Saint Louis, MO 63117-1854 | 2005-08-28 |
| 1891135398 | Jennifer Marie Moore | Internal Medicine | 1035 Bellevue Ave, Suite 400, Saint Louis, MO 63117-1854 | 2013-06-28 |
| 1720348600 | Edward W Heidbrier Md PC | Internal Medicine | 1035 Bellevue Ave, Suite 105, Saint Louis, MO 63117-1854 | 2012-05-24 |
| 1831487719 | Dany Varughese Thekkemuriyil | Internal Medicine | 1035 Bellevue Ave, Suite 500, Saint Louis, MO 63117-1854 | 2011-07-13 |
| 1659670552 | Ann M Armstrong | Nurse Practitioner | 1035 Bellevue Ave, Suite 500, Saint Louis, MO 63117-1854 | 2011-03-18 |
| 1245542042 | J.c. Redington, Md Inc | Internal Medicine | 1035 Bellevue Ave, Ste 105, Saint Louis, MO 63117-1854 | 2010-07-08 |
| 1932430097 | April Lampkin | Nurse Practitioner | 1035 Bellevue Ave, Suite 316, Saint Louis, MO 63117-1854 | 2010-01-28 |
| 1265662050 | Erica Edith Martin | Nurse Practitioner | 1035 Bellevue Ave, Suite 502, Saint Louis, MO 63117-1854 | 2009-07-15 |
| 1497983787 | John P Durbin | Internal Medicine | 1035 Bellevue Ave, 400, Saint Louis, MO 63117-1854 | 2009-06-25 |
| 1053547539 | Rishi Kranth Vasireddy | Family Medicine | 1035 Bellevue Ave, Suite 305, Saint Louis, MO 63117-1854 | 2009-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215359484 | Advanced Gastroenterology & Colon Cancer Screening Center LLC | Internal Medicine | 763 S New Ballas Rd # 265, Saint Louis, MO 63141-8704 | 2014-01-07 |
| 1689014276 | Antonio Ricardo Cheesman Rocca | Internal Medicine | 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104-1016 | 2013-06-27 |
| 1720346729 | Kayci Renee Huff-hardy | Internal Medicine | 621 S New Ballas Rd Ste 437a, Saint Louis, MO 63141-8259 | 2012-04-26 |
| 1750676664 | Parul Gor | Internal Medicine | 615 S New Ballas Rd Ste 1200, Saint Louis, MO 63141 | 2011-06-20 |
| 1902034499 | Giao Vuong | Internal Medicine | 6400 Clayton Rd Ste 216, Saint Louis, MO 63117-1850 | 2009-06-23 |
| 1790908820 | Kishore Maganty | Internal Medicine | 522 N New Ballas Rd Ste 210, Saint Louis, MO 63141-6829 | 2007-04-10 |
| 1043309792 | Robert M Mcmahon | Internal Medicine | 1610 Des Peres Rd Ste 150, Saint Louis, MO 63131-1863 | 2006-10-12 |
| 1154418119 | Hugo A Villarreal | Internal Medicine | 13276 Manchester Rd, Saint Louis, MO 63131-1706 | 2006-10-09 |
| 1952494932 | Muhammad A. Nyazee | Internal Medicine | 11155 Dunn Rd Ste 212e, Saint Louis, MO 63136-6166 | 2006-10-02 |
| 1487745360 | David J Costigan | Internal Medicine | 10007 Kennerly Rd, Saint Louis, MO 63128-2179 | 2006-09-27 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
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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.