Jeffrey Randall Frerking

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2025023940 Issued in MO

Practice address

1195 N Oakland Ave
Bolivar, MO 65613-8095

Phone

(417) 777-2121

Fax

(918) 619-4334

NPI assigned

Apr 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Pediatric Medicine

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfrerking701512@ahs.direct-ci.com

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Pediatrics

  Medicare reassignment NPD
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Citizens Memorial Healthcare

  dba Butterfield Park Pediatrics

  • Rural Health Clinic/Center
  • Bolivar, MO
  • NPI 1942414610
  NPD (past)
• Citizens Memorial Hospital District

  dba Citizens Memorial Hospital

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  NPD (past)

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1649915273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138095",
            "telephone_number": "417-777-2121",
            "fax_number": "918-619-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138095",
            "telephone_number": "417-777-2121",
            "fax_number": "918-619-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRERKING",
        "first_name": "JEFFREY",
        "middle_name": "RANDALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-28",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2025023940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kolby Thomas Follis, FNP-C
• Katharine Hendrix Foster, MS
• Kole Daniel Foster, DPT
• Meagan Francka, SLPA
• Free Your Mind Therapy LLC
• Lynae Rachelle Friend, PMHNP
• Alexis Garner, DMD
• Alexander K Gerry, PLPC
• Melissa Gibbs, PA-C
• Erin Giglio

• Pediatrics Physician in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.