Mary L Fredrick, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20853 Issued in SC

Practice address

731 Polo Road
Columbia, SC 29223

Phone

(800) 491-0909

NPI assigned

Mar 15, 2017

Sex

Female

Sole proprietor

No

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

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Medical LLCGroup PAC ID 5496056814, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EIFJBD

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.

• Gateway Medical LLC

  • Family Medicine Physician
  • Lexington, SC
  • NPI 1649647884
  Medicare reassignment Care Compare group
• Pain Medicine Specialists, PA

  • Interventional Pain Medicine Physician
  • West Columbia, SC
  • NPI 1679118657
  Medicare reassignment NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  Medicare reassignment NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Irmo, SC
  • NPI 1609410794
  NPD
• Homestead Hospice of Columbia LLC

  • Community Based Hospice Care Agency
  • Irmo, SC
  • NPI 1245603455
  NPD (past)
• Palmetto Orthopaedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1841291127
  NPD (past)

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1376084970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 MAIN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012818",
            "telephone_number": "803-726-2350",
            "fax_number": "803-753-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 POLO ROAD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29223",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiquita Antwanette Frederick
• Jason Frederick
• Keven Frederick
• Paul G Fredette, M.D.
• Janet Jackson Fredrick
• Zamuel Fredrick
• Zandria Darcel Fredrick, APRN
• Free Service LLC
• Whitney Free-Jenkins, DMD
• Sabrina Marina Free, FNP

• Family Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.

Verify at the official NPI Registry.