Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy Marie Frederickson

Individual provider Occupational Therapist · NPI 1922932276

Amy Marie Frederickson is an Occupational Therapist in Private Practice in Fort Wayne, Indiana. Qualified in 2021, 5 years ago. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2026
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Practice location Address checks out

12844 Coldwater Rd Ste B
Fort Wayne, IN 46845-8833
Phone: (260) 497-7191
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 31007557A (IN)

Record details

NPI number1922932276
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 11, 2026
Last updated in NPPESJune 11, 2026
Certification dateJune 11, 2026
Mailing address9823 Auburn Rd, Fort Wayne, IN 46825-2347

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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