Individual provider Active NPI

Jeffrey L Frederich, M.D.

  • Family Medicine Physician
  • Paducah, KY
National Provider Identifier
1508882010
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43994-A Issued in KY
Practice address
120 Pershing Way
Paducah, KY 42001-8914
Phone
(270) 816-7526
Fax
(270) 908-8322
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 43994 KY
Family Medicine Physician 207Q00000X 43994-A KY Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 43994 KY
Emergency Medicine Physician 207P00000X 43994 KY

Addresses

Primary practice location

120 Pershing Way
Paducah, KY 42001-8914

Mailing address

3805 Still Meadow LN
Lexington, KY 40509-2951
Phone (270) 816-7526

Other identifiers 2

IdentifierTypeStateIssuer
7100109070MedicaidKY
43994OtherKYKENTUCKY MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL2 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
I20100415000751 KY Practitioner - Family Practice 3779610167 Reassigns benefits to 6 organizations
I20180510001213 IL Practitioner - Emergency Medicine 3779610167 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43994-AKYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the East, PA Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Statera Health Care, LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Concord Company of Tennessee PLLC Emergency Medicine CurrentSince Jan 2, 2024 Accepting new patients
Trigg County Hospital, Inc Emergency Medicine CurrentSince May 5, 2015 Accepting new patients
Integritas Emergency Physician Services, LLC Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Trigg County Hospital, Inc Family Medicine CurrentSince May 5, 2015 Accepting new patients
Marshall Emergency Services Associates, PLLC Emergency Medicine Past Accepting new patients
Elite Emergency Services of Kentucky, PLLC Emergency Medicine Past Accepting new patients

Locations

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

28 Chick St
Metropolis, IL 62960
Phone (618) 427-2680

723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

60 Mercy Ct
Irvine, KY 40336
Phone (606) 723-2115

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

10200 Forest Green Blvd
Ste 112
Louisville, KY 40223
Phone (502) 214-5343

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1501 S Dixie St
Park, KY 42749
Phone (270) 745-1255

850 Riverview Ave
Pineville, KY 40977
Phone (606) 337-3051

Interoperability endpoints

  • Direct secure messaging: jfrederich@yourcarecommunity.org

Organizations & group practices 10

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.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Post Acute Care Physicians of the East PA 56 clinicians

Practice addresses (Care Compare)

20 County Barn Rd
Booneville, KY 41314-6500
Phone (606) 593-6302

260 S Mayo TRL
Pikeville, KY 41501-1520
Phone (606) 437-7327

700 Mason Headley Rd
Lexington, KY 40504-2326
Phone (859) 276-1083

Hospital & facility affiliations

  • Pineville Community Health Center, Inc Hospital, Pineville, KY, CCN 180154
  • Kentucky River Medical Center Hospital, Jackson, KY, CCN 181334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue153
Removal of skin lesions24

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1508882010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 STILL MEADOW LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092951",
            "telephone_number": "270-816-7526",
            "fax_number": "270-908-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PERSHING WAY",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420018914",
            "telephone_number": "270-816-7526",
            "fax_number": "270-908-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICH",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "43994",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "43994-A",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "43994",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "43994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100109070",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAL LICENSE",
            "identifier": "43994",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.