Individual provider Active NPI

Roxane Jeanne Fredette, FNP

  • Nurse Practitioner
  • Fairhaven, MA
National Provider Identifier
1467618421
Registry record updated Sep 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN151295 Issued in MA
Practice address
200 Mill Rd
Fairhaven, MA 02719-5252
Phone
(508) 973-3200
Fax
(508) 973-3215
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN151295 MA Primary

Addresses

Primary practice location

200 Mill Rd
Fairhaven, MA 02719-5252

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rfredette40029@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081106000705 MA Practitioner - Nurse Practitioner 7012076904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

206 Mill Rd
Fairhaven, MA 02719-5208
Phone (508) 973-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN151295MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jul 26, 2017 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 26, 2017 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

206 Mill Rd
Fairhaven, MA 02719
Phone (508) 973-3000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

Interoperability endpoints

  • Direct secure messaging: rfredette40029@direct.southcoast.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1467618421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-3200",
            "fax_number": "508-973-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "ROXANE",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN151295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfredette40029@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "206 Mill Rd",
            "city": "Fairhaven",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027195208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.