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TATEM FREDRICKSON DO
NPI 1255273785
Student in an Organized Health Care Education/Training Program in Coeur D Alene, ID

Active since April 06, 2026PECOS Enrolled
1919 LINCOLN WAY STE 315, COEUR D ALENE, ID 83814(208) 625-4255 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tatem Fredrickson Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TATEM FREDRICKSON DO (NPI 1255273785) is an individual student in an organized health care education/training program in Coeur D Alene, Idaho and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255273785
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameTATEM FREDRICKSONCredential: DO
Location Address1919 LINCOLN WAY STE 315Coeur D Alene, ID 83814-2527
Mailing Address1219 E Washington StBoise, ID 83712-7328
Phone(208) 625-4255
Sole ProprietorNo
Enumeration DateApril 6, 2026
NPPES CertifiedApril 6, 2026
✔ NPI 1255273785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1919 LINCOLN WAY STE 315, Coeur D Alene, ID 83814
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tatem Fredrickson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW C. BEAN MD
Family Medicine
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
RACHEL SIMMONS
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
MADYSON BURTNER
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
MATTHEW JOSEPH RORKE MD
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6029
DR. BROOKE ELLEN POTRATZ MD
Family Medicine
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
RICHARD A MCLANDRESS M.D.
Family Medicine
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
SARAH CHRISTINE JORDAN MD
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
MADELINE MAY
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tatem Fredrickson's NPI number?

The NPI number for Tatem Fredrickson is 1255273785. It was assigned to this individual provider in the NPPES registry on April 6, 2026.

Where is Tatem Fredrickson located?

Tatem Fredrickson practices at 1919 Lincoln Way Ste 315, Coeur D Alene, ID 83814. The listed phone number is (208) 625-4255.

What is Tatem Fredrickson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tatem Fredrickson enrolled in Medicare?

Yes. Tatem Fredrickson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tatem Fredrickson was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.