Individual provider Active NPI

Fred Jay Frazier III, APRN,PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksburg, WV
National Provider Identifier
1043620461
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN79419-PMHNP-BC Issued in WV
Practice address
3 Hospital PLZ
Clarksburg, WV 26301-9316
Phone
(304) 969-3100
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN79419-PMHNP-BC WV Primary

Addresses

Primary practice location

3 Hospital PLZ
Clarksburg, WV 26301-9316

Mailing address

224 Thompson Dairy Rd
Farmington, WV 26571-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20141001002542 WV Practitioner - Nurse Practitioner 4981824539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William R Sharpe Jr HospitalGroup PAC ID 8224949383, 19 clinicians

Practice addresses (Care Compare)

936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone (304) 269-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
William R Sharpe Jr Hospital CurrentSince Nov 1, 2019 Accepting new patients
Davis Memorial Hospital CurrentSince May 1, 2023 Accepting new patients
Highland-Clarksburg Hospital CurrentSince Jun 2, 2018 Accepting new patients
William R. Sharpe, Jr. Hospital CurrentSince Nov 1, 2019 Accepting new patients
Davis Memorial Hospital CurrentSince May 1, 2023 Accepting new patients

Locations

3 Hospital Plz
Clarksburg, WV 26301
Phone (304) 621-2121

812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300

936 Sharpe Hospital Rd
Weston, WV 26452
Phone (304) 269-1210

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1043620461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 THOMPSON DAIRY RD",
            "city": "FARMINGTON",
            "state": "WV",
            "postal_code": "265719000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019316",
            "telephone_number": "304-969-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "FRED",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "APRN,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "APRN79419-PMHNP-BC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

Verify at the official NPI Registry.