Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1881660306 Deactivated / Inactive NPI Male Practitioner

Dr. David Lee Frederickson , MD

Emergency Medicine • St Cloud, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Frederickson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 24, 2006
NPI Deactivation Date September 20, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. David Frederickson, MD was a registered Emergency Medicine practicing in St Cloud, MN. Throughout an active medical career spanning 15 years, Dr. Frederickson provided care at the practice location at 1406 6TH AVE N until profile deactivation on 2021-09-20.

Practice Location & Contact Primary Location

Practice Address

1406 6th Ave N

St Cloud, MN 563031901

Telephone 3202555657
Associated Practice Facility / Clinic
🏢 St Cloud Pathologists Pa Facility NPI 1396717633

Specialty Benchmarks & Practice Insights

Comparative analytics for Emergency Medicine in St Cloud, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
11 Specialists

Practicing in St Cloud, MN (1376 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Emergency Medicine Primary Specialty

NUCC Taxonomy Code: 207P00000X

State License MN 18159

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Stephen Bologna

Pathology - Clinical Pathology/Laboratory Medicine

NPI 1053383026
Dr. Daniel Fark , MD

Emergency Medicine

NPI 1144293945

Doctor of Medicine (M.D.)

Dr. Joseph Randolph , MD

Emergency Medicine

NPI 1164497830

Doctor of Medicine (M.D.)

Dr. Michael Butts , MD

Emergency Medicine

NPI 1235102039

Doctor of Medicine (M.D.)

Dr. Anthony Haas , MD

Emergency Medicine

NPI 1326011933

Doctor of Medicine (M.D.)

Dr. John Mertz , MD PHD

Emergency Medicine

NPI 1346217874

MDPHD

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 20, 2021

Record deactivated on September 20, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1406 6TH AVE N, ST CLOUD, MN 563031901 (Tel: 3202555657)

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Updated Business Mailing Address July 08, 2007

Registered at 1406 6TH AVE N, SAINT CLOUD, MN 563031900 (Tel: 3202555657)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DAVID FREDERICKSON, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Emergency Medicine (License #18159 in MN)

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Initial NPI Registration & Enumeration February 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881660306
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 24, 2006
Last Update: July 08, 2007
Deactivation Date: September 20, 2021

Mailing Address

1406 6th Ave N

Saint Cloud, MN 563031900

Phone: 3202555657

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.