Jordan Zentmeyer Fredrickson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0001279981 Issued in VA

Practice address

5741 Cleveland St Ste 150
Virginia Beach, VA 23462-1777

Phone

(757) 422-5502

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Tidewater Lactation Group, Inc.

  • Lactation Consultant (Registered Nurse)
  • Virginia Beach, VA
  • NPI 1790999621
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1154049922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 CLEVELAND ST STE 150",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621777",
            "telephone_number": "757-422-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 CLEVELAND ST STE 150",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621777",
            "telephone_number": "757-422-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "JORDAN",
        "middle_name": "ZENTMEYER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001279981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryanne Ruth Frazier, PHARMD
• Michelle Lee Frazier
• Miranda Frazier, LCSW
• Frederick P Ochave, DMD PLLC
• Frederick Quarles
• Freedom Care Company
• Freedom Counseling
• Freedom Family Services LLC
• Freedom Wellness, LLC
• Freeman Cares Transport LLC

• Registered Nurse in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.