Nicholas Henry Frederiksen, APRN,CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R41352 Issued in ND

Practice address

3000 32ND Ave S
Fargo, ND 58103-6132

Phone

(701) 364-8000

Fax

(701) 364-8078

NPI assigned

Sep 17, 2014

Last updated

Dec 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Care CenterGroup PAC ID 1658283650, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Fargo, ND
  • NPI 1710066352
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1013319334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "NICHOLAS",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ND",
            "license": "R41352",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "R41352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1463647",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fraser, LTD
• Fraser, LTD.
• Fraser, LTD.
• Jodi Freden
• Brea Christine Frederick
• Kirsten Fredrick, LPCC
• Amy Fredrickson, LPN
• Amy Freeberg
• Erika Freeberg, LBSW
• Kathleen Freebern

• Adult Health Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Adult Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.