NPIMap

Individual provider Active NPI

Jennifer Lee Frederick, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1497835169
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5096A Issued in KY
Practice address
320 Whittington Pkwy
Suite 301
Louisville, KY 40222-4928
Phone
(502) 625-5584
Fax
(502) 426-2264
NPI assigned
Oct 17, 2006
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 5096A KY Primary

Addresses

Primary practice location

320 Whittington Pkwy
Suite 301
Louisville, KY 40222-4928

Mailing address

320 Whittington Pkwy
Suite 301
Louisville, KY 40222-4928
Phone (502) 625-5584

Other identifiers 4

IdentifierTypeStateIssuer
50016501OtherKYPASSPORT
7100025040MedicaidKY
2867285000OtherKYPASSPORT ADVANTAGE
200873920MedicaidIN

Other names 1

  • Jennifer Lee Garvin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070915000148 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981701547 Reassigns benefits to 1 organization
I20251223000667 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981701547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians
Apollo Medical Group of Jeffersonville LLCGroup PAC ID 8729487897, 25 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

400 Corporate Dr
Suite 100
Jeffersonville, IN 47130-1502
Phone (812) 925-1051

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
5096AKYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Apollo Medical Group of Jeffersonville LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 12, 2025 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2018 Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
U S Anesthesia Partners of Kentucky PSC Nurse Anesthetist, Certified Registered PastSince Jul 1, 2023 Accepting new patients
One Anesthesia PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

400 Corporate Dr
Ste 100
Jeffersonville, IN 47130
Phone (502) 693-5292

2990 Gottbrath Pkwy
Jeffersonvlle, IN 47130
Phone (812) 670-0990

850 S 28th St
Louisville, KY 40211
Phone (502) 629-7650

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

4960 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-8000

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 5

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1497835169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WHITTINGTON PKWY",
            "address_2": "SUITE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224928",
            "telephone_number": "502-625-5584",
            "fax_number": "502-426-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WHITTINGTON PKWY",
            "address_2": "SUITE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224928",
            "telephone_number": "502-625-5584",
            "fax_number": "502-426-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "5096A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50016501",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100025040",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2867285000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200873920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GARVIN",
            "middle_name": "LEE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.