Individual provider Active NPI

Jacquelyne Anne Friebis, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1033040597
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC041 Issued in KY
Practice address
1 Trillium Way
Corbin, KY 40701-8426
Phone
(606) 528-1212
Fax
(606) 528-8661
NPI assigned
May 26, 2026
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC041 KY Primary
Medical Physician Assistant 363AM0700X TC041 KY

Addresses

Primary practice location

1 Trillium Way
Corbin, KY 40701-8426

Mailing address

1 Trillium Way
Corbin, KY 40701-8426
Phone (606) 528-1212

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: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1779753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1033040597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426",
            "telephone_number": "606-528-1212",
            "fax_number": "606-528-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426",
            "telephone_number": "606-528-1212",
            "fax_number": "606-528-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEBIS",
        "first_name": "JACQUELYNE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-26",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC041",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "TC041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.