AMANDA FREDERIKSEN (NPI# 1245785633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245785633 |
| Entity Type | Individual |
| Full Name | AMANDA FREDERIKSEN |
| Practice Address |
3330 Inner Perimeter Rd Valdosta GA 31602-7063 |
| Mailing Address |
6600 Beatty Mill Creek Rd Ray City GA 31645-2010 |
| Practice Telephone | 2296719840 |
| Mailing Telephone | 2298349869 |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH029220 | GA | Pharmacy Service Providers |
| Street Address |
3330 INNER PERIMETER RD |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-7063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265779102 | Shannon Renee Knight | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602 | 2013-01-11 |
| 1417502428 | Mary Elizabeth Finch | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602-7063 | 2019-08-06 |
| 1336621010 | Carrie Shae Revels | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602-7063 | 2018-08-30 |
| 1225551005 | Meghan Ann Collins | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602-7063 | 2017-07-24 |
| 1184024382 | Christina Duckworth | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602-7063 | 2014-08-26 |
| 1770822728 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 3330 Inner Perimeter Rd, Valdosta, GA 31602-7063 | 2013-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528668175 | Vishwa Patel | Pharmacist | 3604 Bellhaven Dr, Valdosta, GA 31605-1210 | 2020-10-31 |
| 1295357606 | Katherine Buescher | Pharmacist | 3532 River Chase Dr, Valdosta, GA 31602-0800 | 2020-05-08 |
| 1881252773 | Kenneth Alan Bethea | Pharmacist | 2202 Fleming St, Valdosta, GA 31602-2501 | 2019-06-05 |
| 1952875684 | Karisa Wilks Zickos | Pharmacist | 3782 Old Us 41 N, Valdosta, GA 31602-6834 | 2019-01-16 |
| 1679047492 | Tammi Creamer | Pharmacist | 404 Hunters Gln, Valdosta, GA 31602-4229 | 2019-01-15 |
| 1770056855 | Haley S Gay | Pharmacist | 3782 Old Us Highway 41 N Ste C, Valdosta, GA 31602-6834 | 2019-01-10 |
| 1346581006 | Dah Chung | Pharmacist | 2300 N Oak St, Valdosta, GA 31602-2517 | 2013-03-06 |
| 1265779102 | Shannon Renee Knight | Pharmacist | 3330 Inner Perimeter Rd, Valdosta, GA 31602 | 2013-01-11 |
| 1992090633 | Mary Katelyn Harper | Pharmacist | 3200 North Oak Street, Valdosta, GA 31605 | 2011-06-10 |
| 1194023820 | Adam Rhett Moore | Pharmacist | 2704 N Oak St Bldg B1, Valdosta, GA 31602 | 2011-03-03 |
| Find all providers in VALDOSTA | ||||
Please comment or provide details below to improve the information on AMANDA FREDERIKSEN.
| 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.