Individual provider Active NPI

Dejuana Nicole Frazier, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1285964551
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006318 Issued in KY
Practice address
2321 Oregon Ave
Louisville, KY 40210-2135
Phone
(502) 523-6915
NPI assigned
Jan 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 3006318 KY Primary

Addresses

Primary practice location

2321 Oregon Ave
Louisville, KY 40210-2135

Mailing address

2321 Oregon Ave
Louisville, KY 40210-2135
Phone (502) 523-6915

Other identifiers 1

IdentifierTypeStateIssuer
7100143080MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Duvalle Community Health Center, Inc. CurrentSince Oct 30, 2010 Accepting new patients
Park Duvalle Community Health Center, Inc CurrentSince Oct 30, 2010 Accepting new patients
Park Duvalle Community Health Center, Inc. Current Accepting new patients

Locations

3015 Wilson Ave
Louisville, KY 40211
Phone (502) 774-4401

3828 Bardstown Rd
Louisville, KY 40218
Phone (502) 459-4900

Organizations & group practices 3

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1285964551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 OREGON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402102135",
            "telephone_number": "502-523-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 OREGON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402102135",
            "telephone_number": "502-523-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "DEJUANA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100143080",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.