ANN MARIE DECKER FREDERICK MD
NPI 1245685064
Psychiatry & Neurology - Child & Adolescent Psychiatry in Villa Rica, GA
NPI Status: Active since April 29, 2016
Contact Information
101 QUARTZ DR STE 103B
VILLA RICA, GA
ZIP 30180
Phone: (770) 812-3530
Fax: (770) 812-3531
- Individual
- Female
- Psychiatry & Neurology
- Child & Adolescent Psychiatry
- PECOS Enrolled
About ANN FREDERICK
This page provides the complete NPI Profile along with additional information for Ann Frederick, a provider established in Villa Rica, Georgia with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry . The healthcare provider is registered in the NPI registry with number 1245685064 assigned on April 2016. The practitioner's primary taxonomy code is 2084P0804X with license number 90877 (GA). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1245685064
- Provider Name
- ANN MARIE DECKER FREDERICK MD
- Other Name
- ANN MARIE DECKER MD
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 101 QUARTZ DR STE 103B VILLA RICA, GA 30180
- Location Phone
- (770) 812-3530
- Location Fax
- (770) 812-3531
- Mailing Address
- 100 GREENWAY BLVD STE C CARROLLTON, GA 30117
- Mailing Phone
- (770) 812-3530
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-29-2016
- Last Update Date
- 12-09-2024
- Code Navigator
Location Map
Secondary Locations
- 2830 Dresden Dr
Atlanta, GA 30341
(404) 315-8333
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Child & Adolescent Psychiatry
- Taxonomy Code
- 2084P0804X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 90877
- License State
- GA
- Taxonomy Description
- Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 90877 (GA) |
| 2 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 63157 (TN) |
| 3 | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 63157 (TN) |
Medicare Participation & PECOS Enrollment Status
Ann Frederick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 4 | 5 | 6 | 8 | 5 | 0 | 6 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 8 | 5 | 12 | 8 | 10 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 8 + 5 + 1 + 2 + 8 + 1 + 0 + 0 + 1 + 2 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1245685064 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1518504257 | AREIAL K STEPHENS Individual | Counselor | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1033756671 | MS. APRIL MONIQUE MCCONICO Individual | Counselor | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1295134492 | MRS. APRIL JILES FORTENBERRY PNP-PC Individual | Nurse Practitioner (Psychiatric/Mental Health) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1467106302 | SHANA HENRY PMHNP-BC Individual | Nurse Practitioner (Psychiatric/Mental Health) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1700506144 | MALIKATA NICOLETTE DANO NP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1356795462 | TMC-BEHAVIORAL HEALTH OF WEST GEORGIA Organization | Psychiatry & Neurology (Geriatric Psychiatry) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1184180069 | MRS. SARAH JOANN MATHEKA PMHNP-BC Individual | Nurse Practitioner (Psychiatric/Mental Health) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1235755406 | LINDA OKAI MD Individual | Psychiatry & Neurology (Psychiatry) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1144031220 | MR. JOHN KAMAU KIARIE Individual | Family Medicine | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1144116419 | JACQUELINE BROWN NP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
| 1649767658 | DR. DARRON RICARDO LEWIS MD Individual | Psychiatry & Neurology (Psychiatry) | 101 QUARTZ DR STE 103B VILLA RICA, GA 30180 (770) 812-3530 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245685064, enumerated in the NPI registry as an "individual" on April 29, 2016
The provider is located at 101 Quartz Dr Ste 103b Villa Rica, Ga 30180 and the phone number is (770) 812-3530
The provider's speciality is Psychiatry & Neurology with taxonomy code 2084P0804X with a focus in Child & Adolescent Psychiatry
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on April 29, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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