Active NPI
Caleb James Fredrickson, MD
- Emergency Medicine Physician
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 96769
- Practice address
- 701 Grove Rd FL 1
Greenville, SC 29605-4210 - Phone
- (864) 455-7899
- Fax
- (864) 455-5474
- NPI assigned
- Jul 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 96769 | SC | Primary |
| Emergency Medicine Physician | 207P00000X | 2023004726 | MO | |
| Medical Toxicology (Emergency Medicine) Physician | 207PT0002X | 96769 | SC |
Addresses
Primary practice location
701 Grove Rd FL 1
Greenville, SC 29605-4210
Mailing address
300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200085152 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 362-9123
400 S Kingshighway Blvd
Saint Louis, MO 63110-1014
Phone (314) 454-7900
Hospital & facility affiliations
- Christian Hospital Northeast
- Barnes Jewish Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023004726 | MO | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University Community Specialists, LLC | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients | |
| Southeastern Emergency Physicians of Memphis LLC | Emergency Medicine | Current | Accepting new patients |
Locations
1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000
1225 Graham Rd
#U
Florissant, MO 63031
1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700
11133 Dunn Rd
#U
Saint Louis, MO 63136
1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170
660 S Euclid Ave
Saint Louis, MO 63110
400 S Kingshighway Blvd
#F
Saint Louis, MO 63110
Phone (314) 454-7900
Organizations & group practices 4
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.
-
- Emergency Care Clinic/Center
- Saint Louis, MO
- NPI 1104866656
-
- Emergency Care Clinic/Center
- Saint Louis, MO
- NPI 1922812254
-
- Emergency Medicine Physician
- Alton, IL
- NPI 1437105277
MO
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1639186760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1114545217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012899",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE RD FL 1",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054210",
"telephone_number": "864-455-7899",
"fax_number": "864-455-5474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDRICKSON",
"first_name": "CALEB",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-06",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "96769",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2023004726",
"primary": false
},
{
"code": "207PT0002X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Medical Toxicology",
"state": "SC",
"license": "96769",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200085152",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Barnes Jewish Hospital Plz",
"address_2": "Dept Emergency Med",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.