Active NPI
Jennifer Frederiksen, MD
- Family Medicine Physician
- Platte, SD
National Provider Identifier
1003127424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9217
- Practice address
- 601 E 7TH St
Platte, SD 57369-2123 - Phone
- (605) 337-3364
- NPI assigned
- Jun 30, 2010
- Last updated
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9217 | SD | Primary |
Addresses
Primary practice location
601 E 7TH St
Platte, SD 57369-2123
Mailing address
601 E 7TH St
Platte, SD 57369-2123
Phone (605) 337-3364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9217 | SD | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1003127424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E 7TH ST",
"city": "PLATTE",
"state": "SD",
"postal_code": "573692123",
"telephone_number": "605-337-3364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E 7TH ST",
"city": "PLATTE",
"state": "SD",
"postal_code": "573692123",
"telephone_number": "605-337-3364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERIKSEN",
"first_name": "JENNIFER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SD",
"license": "9217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Platte, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.