George Fredericks IV, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Blountville, TN
NPI 1629798384 · NPPES record last updated Dec 12, 2022
Key facts
- NPI
- 1629798384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 32503 (TN)
- Practice address
- 1913 Highway 394
Blountville, TN 37617-5349 - Phone
- (423) 662-7002
- Fax
- (423) 662-7003
- NPI assigned
- Aug 31, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Karing Hearts Cardiology PC
Practice addresses (Care Compare)
701 N State of Franklin Rd
Suite 2
Johnson City, TN 37604-3645
Phone (423) 926-4468
Hospital & facility affiliations
- Johnson City Medical Center
- Franklin Woods Community Hospital
- Sycamore Shoals Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221221001856 | TN | Practitioner - Nurse Practitioner | 9931579679 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000192577 | TN | MD | Registered Nurse |
| 32503 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karing Hearts Cardiology Heart and Vascular Center | Current |
Accepting new patients | |
| Karing Hearts Cardiology PC | Current |
Accepting new patients | |
| Karing Hearts Cardiology, PLLC | Past | Accepting new patients |
Locations
1503 W Elk Ave
Ste 8
Elizabethton, TN 37643
Phone (423) 542-0400
627 N Main Ave
Erwin, TN 37650
Phone (423) 735-3405
701 N State of Franklin Rd
Ste 9
Johnson City, TN 37604
Phone (423) 850-0776
701 N State of Franklin Rd
Ste 2
Johnson City, TN 37604
Phone (423) 477-0600
600 N State of Franklin Rd
Ste 8
Johnson City, TN 37604
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0000192577 | TN | |
| Family Nurse Practitioner | 363LF0000X | 32503 | TN | Yes |
Addresses
Primary practice location
1913 Highway 394
Blountville, TN 37617-5349
Mailing address
1913 Highway 394
Blountville, TN 37617-5349
Phone (423) 662-7002
Other practice location 1
132 Treadway St
Elizabethton, TN 37643-7642
Phone (423) 440-3095
Other providers in Blountville, TN
- Kari D Farmer
- Fast Pace Medical Clinic PLLC
- Karen M Feeley
- Julia Fitchett
- Suzanne Gayle Folkner
- Fritts Family Chiropractic, Inc.
- David Shannon Fritts
- Brandan Glazier
- Julie Shannon Glenn
- Chrystal Gail Gortney
All providers in Blountville, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.