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MELANIE C. FREDERICK MD NPI 1720062235


NPI Information

NPI: 1720062235
Provider Name: MELANIE C. FREDERICK, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 19D0982790

Address:
2508 BERT KOUNS LOOP
SUITE 103
SHREVEPORT, LA
ZIP 71118
Phone: (318) 687-5277
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Melanie C. Frederick, MD is a family medicine in Shreveport, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Melanie C. Frederick, MD NPI is 1720062235. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2508 BERT KOUNS LOOP
SUITE 103
SHREVEPORT, LA
ZIP 71118-133
Phone: (318) 687-5277
Fax: (318) 687-5386

The NPI 1720062235 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 19D0982790 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2005 and was last updated on 1/30/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine017823LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15N584MEDICARE PINLOUISIANA
2E91173MEDICARE UPIN
35N584DC14MEDICARE PINLOUISIANA
41919357MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.