Individual provider Active NPI

Jennifer J Frerichs, APRN

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1154706430
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
76872 Issued in KS
Practice address
4722 W Kellogg Dr
Wichita, KS 67209-2508
Phone
(316) 440-2565
Fax
(316) 440-2750
NPI assigned
Jul 28, 2015
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 76872 KS Primary

Addresses

Primary practice location

4722 W Kellogg Dr
Wichita, KS 67209-2508

Mailing address

4722 W Kellogg Dr
Wichita, KS 67209-2508
Phone (316) 440-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150826002553 KS Practitioner - Nurse Practitioner 7315260981 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76872KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Psychiatric Services, LLC CurrentSince Apr 1, 2020 Accepting new patients
Restoration Health Care LLC CurrentSince Jan 1, 2021 Accepting new patients
Signify Health Medical Associates of Kansas LLC CurrentSince Nov 8, 2023 Accepting new patients
Mobile Medical II, LLC PastSince Jun 30, 2024 Accepting new patients

Locations

1541 N Lindberg Cir
Wichita, KS 67206
Phone (316) 258-5882

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, 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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1154706430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 W KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092508",
            "telephone_number": "316-440-2565",
            "fax_number": "316-440-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 W KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092508",
            "telephone_number": "316-440-2565",
            "fax_number": "316-440-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRERICHS",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "76872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.