Individual provider Active NPI

Judy D Frueh, WHNP

  • Women's Health Nurse Practitioner
  • Maryville, MO
National Provider Identifier
1386675783
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
104080 Issued in MO
Practice address
800 University Dr
Maryville, MO 64468-6015
Phone
(660) 562-1348
Fax
(660) 562-1585
NPI assigned
Jul 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 104080 MO Primary

Addresses

Primary practice location

800 University Dr
Maryville, MO 64468-6015

Mailing address

800 University Dr
Maryville, MO 64468-6015
Phone (660) 562-1348

Other identifiers 1

IdentifierTypeStateIssuer
428306419MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20060821000466 MO Practitioner - Nurse Practitioner 8729081393 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Missouri State University CurrentSince Sep 30, 2013 Accepting new patients

Locations

800 University Dr
Maryville, MO 64468
Phone (660) 562-1313

Organizations & group practices 1

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386675783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 UNIVERSITY DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644686015",
            "telephone_number": "660-562-1348",
            "fax_number": "660-562-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 UNIVERSITY DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644686015",
            "telephone_number": "660-562-1348",
            "fax_number": "660-562-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUEH",
        "first_name": "JUDY",
        "middle_name": "D",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "104080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428306419",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.