Individual provider Active NPI

Renee Nicole Frederick, MD

  • Family Medicine Physician
  • Covington, GA
National Provider Identifier
1497381503
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94602 Issued in GA
Practice address
5126 Hospital Dr NE
Covington, GA 30014-2566
Phone
(770) 786-7053
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-16074 AR
Family Medicine Physician 207Q00000X 94602 GA Primary

Addresses

Primary practice location

5126 Hospital Dr NE
Covington, GA 30014-2566

Mailing address

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230130002065 AR Practitioner - Family Practice 4688045636 Reassigns benefits to 12 organizations
I20231120001358 GA Practitioner - HospitalistPractitioner - Family Practice 4688045636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Anemonefish Inpatient Services LLCGroup PAC ID 7012236664, 33 clinicians

Practice addresses (Care Compare)

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-3900

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-16074ARMDFamily Medicine Physician
94602GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Paris CurrentSince Mar 1, 2023 Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Jan 20, 2023 Accepting new patients
Mercy Hospital Booneville Current Accepting new patients
Mercy Hospital Paris CurrentSince Mar 1, 2023 Accepting new patients
Anemonefish Inpatient Services LLC CurrentSince Oct 17, 2023 Accepting new patients
Mercy Hospital Waldron Current Accepting new patients
Mercy Hospital Ozark CurrentSince Mar 1, 2023 Accepting new patients
Mercy Hospital Waldron CurrentSince Mar 1, 2023 Accepting new patients
Mercy Hospital Ozark CurrentSince Mar 1, 2023 Accepting new patients
Ess of Fordyce LLC CurrentSince Jan 20, 2023 Accepting new patients
Mercy Hospital Waldron Current Accepting new patients
Mercy Hospital Booneville CurrentSince Mar 1, 2023 Accepting new patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Sep 29, 2025 Accepting new patients
Mercy Hospital Waldron CurrentSince Mar 1, 2023 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Jan 20, 2023 Accepting new patients
Ies HSP Arkansas PLLC CurrentSince Feb 8, 2023 Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

880 W Main St
Booneville, AR 72927
Phone (479) 675-2800

128 Daniel Dr
Booneville, AR 72927
Phone (479) 675-2455

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

801 W River St
Ozark, AR 72949
Phone (479) 667-4138

500 E Academy St
Paris, AR 72855
Phone (479) 963-6101

1341 W 6th St
Waldron, AR 72958
Phone (479) 637-2136

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

Interoperability endpoints

  • Direct secure messaging: rfrederick1184086@direct.emory.org

Organizations & group practices 16

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.

View all 16

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1497381503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142566",
            "telephone_number": "770-786-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142566",
            "telephone_number": "770-786-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "RENEE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16074",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "94602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

Verify at the official NPI Registry.