DR. JOHN FREDERICK (NPI# 1598027153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598027153 |
| Entity Type | Individual |
| Full Name | DR. JOHN FREDERICK |
| Credential | M.D. |
| Practice Address |
24 Joliet St Ste 101 Dyer IN 46311 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 2198652141 |
| Mailing Telephone | 3175284800 |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2019-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 01076100A | IN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 036138817 | IL | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 01076100A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN | F400244803 | 01 |
| IN | 201338270 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2525 S Michigan Ave, Attn:internal Medicine Residency Program, Chicago, IL 60616 | 3125672053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275976953 | John William Frederick | Student in an Organized Health Care Education/Training Program | 4168 Highlands Cir, Birmingham, AL 35213-2800 | 2013-04-11 |
| 1790828911 | John Thomas Frederick | Psychiatry & Neurology | 1200 5th Ave Ste 2010, Seattle, WA 98101-3100 | 2007-02-15 |
| 1285022400 | John Frederick Jr. | Counselor | 2100 Comer Ave, Columbus, GA 31904-8725 | 2014-12-23 |
| 1073890851 | John M Frederick | Pharmacist | 206 Crossings Ln, Mount Juliet, TN 37122-8547 | 2011-11-08 |
| 1932303815 | John Thomas Frederick | Surgery | 630 13th St, Suite 250, Augusta, GA 30901-1015 | 2007-06-13 |
| 1841347937 | John Frederick | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1001 Blythe Blvd, Ste 300- Adult Cardiology, Charlotte, NC 28203-5866 | 2007-01-04 |
| 1265469332 | John J Frederick | Radiology | 3346 Lennon Rd, Suite 2, Flint, MI 48507-1082 | 2006-06-26 |
| 1043297492 | John Charles Frederick | Ophthalmology | 777 Tanglefoot Ln, Eye Surgeons Associates PC, Bettendorf, IA 52722 | 2005-12-28 |
| 1578546610 | John W Frederick | Family Medicine | 6835 Austin Center Blvd, Austin, TX 78731-3166 | 2005-11-22 |
| 1669453213 | John Randall Frederick | Surgery | 1650 Huntingdon Pike, Suite 154, Meadowbrook, PA 19046-8004 | 2005-11-10 |
| Street Address |
24 JOLIET ST STE 101 |
| City | DYER |
| State | IN |
| Zip Code | 46311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588730063 | Revathy Ameeruddin | Physical Medicine & Rehabilitation | 24 Joliet St Ste 101, Dyer, IN 46311-1705 | 2006-11-28 |
| 1285909382 | Abdulrahman Baig | Internal Medicine | 24 Joliet St Ste 101, Dyer, IN 46311-1705 | 2012-03-21 |
| 1669702106 | St Margaret Mercy Healthcare Centers, Inc | Otolaryngology | 24 Joliet St Ste 101, Dyer, IN 46311-1705 | 2010-01-06 |
| 1588826531 | Ritesh Panwar | Internal Medicine | 24 Joliet St Ste 101, Dyer, IN 46311 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407338858 | Leena Yousef-diaz | Nurse Practitioner | 1100 Joliet Street Suite #201, Dyer, IN 46311 | 2018-09-02 |
| 1518476639 | Kor Speech Therapy, LLC | Speech-Language Pathologist | 219 Primrose Dr., Dyer, IN 46311 | 2017-09-20 |
| 1861921207 | Derrick Durrah | Counselor | 2615 James Drive, Dyer, IN 46311 | 2017-06-08 |
| 1073962189 | Maria Lule | Pharmacist | 805 Joliet Road, Dyer, IN 46311 | 2016-06-09 |
| 1780072157 | Mario Munoz | Skilled Nursing Facility | 515 Audrey Ct, Dyer, IN 46311 | 2015-01-07 |
| 1457772451 | Lisa Jennifer Mickelson | Registered Nurse | 600 Joliet St., Kahler Middle School, Dyer, IN 46311 | 2013-12-18 |
| 1285055285 | Tanya D Burk-willson | Registered Nurse | 14600 W 81st St., Bibich Elementary, Dyer, IN 46311 | 2013-12-18 |
| 1013338011 | Mary Beth Rinaldi | Registered Nurse | 1121 Harrison Ave, Protsman Elementary, Dyer, IN 46311 | 2013-12-18 |
| 1023448057 | Franciscan Alliance | General Acute Care Hospital | 24 Joliet Street, 3da, Dyer, IN 46311 | 2013-11-12 |
| 1508078239 | Fatima Jaffer Md Sc PC | Internal Medicine | Physicians Pavilion Suite 101, 24 East Joliet Street, Dyer, IN 46311 | 2007-05-04 |
| Find all providers in zip 46311 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992877898 | St Margaret Mercy Healthcare Centers Inc | Hospitalist | 24 Joliet St, Dyer, IN 46311-1705 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865159 | Nichole Renee Sebesky | Hospitalist | 629 Park Dr, Franklin, IN 46131-7685 | 2020-09-10 |
| 1407239114 | Thomas Ryan Cervone | Hospitalist | Tristar Southern Hills Medical, 391 Wallace Road, Nashville, IN 37211 | 2015-06-30 |
| 1104194547 | Select Specialty Hospital - Evansville, LLC | Hospitalist | 400 Se 4th St, Evansville, IN 47713-1206 | 2011-12-13 |
| 1073826780 | Indiana University Health Starke Hospital LLC | Hospitalist | 102 East Culver Road, Knox, IN 46534-2216 | 2010-07-22 |
| 1295863199 | Jason S. Henderson | Hospitalist | 6404 Cotton Bay Dr N, Indianapolis, IN 46254-4528 | 2007-03-01 |
| 1619087707 | Shelene S. Ruggio | Hospitalist | 503 Steeplechase Dr, Auburn, IN 46706-9127 | 2006-08-30 |
| 1427161801 | Krishna Datta | Hospitalist | 2520 E. Dupont Road, Fort Wayne, IN 46825 | 2006-08-17 |
| 1003884404 | Srinivasu Kesa | Hospitalist | 3471 Muirfield Way, Carmel, IN 46032 | 2006-03-10 |
| 1154321099 | Johnson Memorial Hospital | Hospitalist | 1155 W Jefferson St, Ste 202, Franklin, IN 46131-2732 | 2005-07-21 |
| 1598387250 | Dana Oberg | Hospitalist | 1915 Lake Ave, Plymouth, IN 46563-9366 | 2020-05-15 |
| Find all providers with the same taxonomy | ||||
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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.