Individual provider Active NPI

Olivia Lynn Fricke, CNM, APRN

  • Advanced Practice Midwife
  • Minneapolis, MN
National Provider Identifier
1033871660
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
472 Issued in MN
Practice address
1919 Nicollet Ave
Minneapolis, MN 55403-3747
Phone
(719) 580-9134
Fax
(612) 236-4745
NPI assigned
Oct 11, 2021
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 472 MN Primary

Addresses

Primary practice location

1919 Nicollet Ave
Minneapolis, MN 55403-3747

Mailing address

1919 Nicollet Ave
Minneapolis, MN 55403-3747
Phone (719) 580-9134

Other names 1

  • Olivia Lynn Wreford Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230303001769 MN Practitioner - Certified Nurse Midwife (CNM) 1850764374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Tree IncGroup PAC ID 5799681615, 7 clinicians

Practice addresses (Care Compare)

1919 Nicollet Ave
Minneapolis, MN 55403-3747
Phone (612) 473-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
472MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Tree Inc CurrentSince Jan 19, 2023 Accepting new patients

Locations

1919 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 445-0225

Interoperability endpoints

  • Direct secure messaging: olivia.wreford.p1@direct.familytreeclinic.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1033871660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033747",
            "telephone_number": "719-580-9134",
            "fax_number": "612-236-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033747",
            "telephone_number": "719-580-9134",
            "fax_number": "612-236-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "OLIVIA",
        "middle_name": "LYNN",
        "credential": "CNM, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "WREFORD",
            "middle_name": "LYNN",
            "credential": "CNM, APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.