NPIMap

Individual provider Active NPI

Jeannine F Frederick, NP

  • Acute Care Nurse Practitioner
  • Covington, LA
National Provider Identifier
1356611339
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN078775-AP05838 Issued in LA
Practice address
121 Sumner St
Covington, LA 70433-1565
Phone
(985) 630-1866
NPI assigned
Jan 6, 2012
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN078775-AP05838 LA Primary

Addresses

Primary practice location

121 Sumner St
Covington, LA 70433-1565

Mailing address

121 Sumner St
Covington, LA 70433-1565
Phone (985) 630-1866

Other identifiers 1

IdentifierTypeStateIssuer
2349988MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140409000937 LA Practitioner - Nurse Practitioner 1153582317 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calcasieu Cameron Hospital Medicine Group LLCGroup PAC ID 1557688421, 66 clinicians

Practice addresses (Care Compare)

211 4TH St
Alexandria, LA 71301-8421
Phone (484) 965-9566

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.75 of 100Reported as group
Quality
71.94
Promoting interoperability
100
Improvement activities
40
Cost
63.89

Merit-based Incentive Payment System (MIPS)

Final score
79.21 of 100Reported as group
Quality
64.85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN078775-AP05838LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Belle Chasse Physician Services LLC CurrentSince Dec 3, 2022 Accepting new patients
Calcasieu Cameron Hospital Medicine Group LLC CurrentSince Mar 1, 2025 Accepting new patients
Gulfsouth Hospital Medicine LLC CurrentSince Jul 1, 2018 Accepting new patients
Gulfsouth Pulmonology, LLC CurrentSince Aug 4, 2018 Accepting new patients
East Jefferson Physicians Group LLC CurrentSince Aug 1, 2023 Accepting new patients
Nni Covington LLC CurrentSince May 6, 2020 Accepting new patients
SLR Holdings LLC Past Accepting new patients
Metairie Physician Services Inc. Past Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

1970 N Highway 190
Covington, LA 70433
Phone (985) 400-5988

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4200 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4331

4228 Houma Blvd
Ste 530
Metairie, LA 70006
Phone (504) 456-8415

4320 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4109

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Organizations & group practices 9

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1356611339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SUMNER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704331565",
            "telephone_number": "985-630-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SUMNER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704331565",
            "telephone_number": "985-630-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JEANNINE",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "RN078775-AP05838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349988",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.