Jon Randall Frederick (NPI# 1003997800, PAC ID# 5193944452) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
Nation Provider ID (NPI) | 1003997800 |
PAC ID by PECOS | 5193944452 |
Professional Enrollment ID | I20140918000700 |
Full Name | Jon Randall Frederick |
Organization Legal Name | BON SECOURS AMBULATORY SERVICES LLC |
Address |
9851 Brook Rd Glen Allen VA 23059-4559 |
Phone Number | 8048938702 |
Gender | M |
Graduation Year | 2006 |
Primary Specialty | EMERGENCY MEDICINE |
Group Practice PAC ID | 6002047313 |
Number of Group Practice Members | 15 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
490112 | CJW MEDICAL CENTER |
260001 | MERCY HOSPITAL JOPLIN |
Address | Phone | Organization |
---|---|---|
9851 Brook Rd, Glen Allen, VA 23059-4559 | 8048938702 | BON SECOURS AMBULATORY SERVICES LLC |
100 Mercy Way, Mercy Clinic Joplin Emergency Medic, Joplin, MO 64804-4524 | 4175562300 | MERCY CLINIC JOPLIN LLC |
Organization Legal Name | BON SECOURS AMBULATORY SERVICES LLC |
Physicians | 13 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kathleen Jensen | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Amanda Nicole Black | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Katherine E Skiff | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Kerry A Boyer | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Tiffany D Kirkham | Physician Assistant | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Philip A Masterson | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Oluwaronke A Awosika | Family Medicine | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Nermine A Saleh | Family Medicine | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Sheree Savage-artis | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Charles K Johnson | Physician Assistant | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Street Address |
9851 BROOK RD |
City | GLEN ALLEN |
State | VA |
Zip | 23059-4559 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kathleen Jensen | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Amanda Nicole Black | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Katherine E Skiff | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Kerry A Boyer | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Tiffany D Kirkham | Physician Assistant | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Philip A Masterson | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Oluwaronke A Awosika | Family Medicine | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Nermine A Saleh | Family Medicine | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Sheree Savage-artis | Nurse Practitioner | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Charles K Johnson | Physician Assistant | Bon Secours Ambulatory Services LLC | 9851 Brook Rd, Glen Allen, VA 23059-4559 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Cherine M Vanwagner | Chiropractic | 11520 Nuckols Rd, Suite 101, Glen Allen, VA 23059-2558 | |
Shoshana D Katz | Physician Assistant | Physical Medicine Associates Ltd | 5213 Hickory Park Dr, B, Glen Allen, VA 23059-2617 |
Andrea M Stern | Psychologist, Clinical | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Beth Mcgraw | Psychologist, Clinical | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Jill Ascari | Psychologist, Clinical | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Sailatha Bobba | Psychiatry | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Kate T Tibbs | Nurse Practitioner | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Allison Revenson | Clinical Social Worker | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Stephanie B Johnson | Psychologist, Clinical | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Wendy S Cohen | Psychiatry | Commonwealth Counseling Associates PC | 5213 Hickory Park Dr A, Glen Allen, VA 23059-2617 |
Find all physicians in zip 23059 |
City | GLEN ALLEN |
Zip Code | 23059 |
Specialty | EMERGENCY MEDICINE |
City + Specialty | GLEN ALLEN + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Jon Randall Frederick.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.