Karen J Fredrick, RN, WHNP, MSN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4412-33 Issued in WI

Practice address

4303 39TH Ave
Kenosha, WI 53144-1969

Phone

(622) 653-4444

Fax

(262) 925-0440

NPI assigned

Sep 23, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: karen.fredrick.1@14940.direct.athenahealth.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.

• Premise Health of Wisconsin Medical SC

  • Multi-Specialty Clinic/Center
  • Kenosha, WI
  • NPI 1760109052
  NPD

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1679569826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 39TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441969",
            "telephone_number": "262-653-4444",
            "fax_number": "262-925-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 39TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441969",
            "telephone_number": "622-653-4444",
            "fax_number": "262-925-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "KAREN",
        "middle_name": "J",
        "credential": "RN, WHNP, MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "78408-030",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4412-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43949100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679569826",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clay Jamison Frank, M.D.
• Emily Elizabeth Franke, OTR/L
• Michael P Frantal, DDS
• Terrence K Frantal, DDS
• Roshonda E Frazier, FNP
• Dorothy Katherine Free
• Jennifer Free, SAC-IT
• Katie Freeland
• Lori Ann Freisinger, OTR
• Fresenius Medical Care Midwest Dialysis, LLC

• All providers in Kenosha, WI
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.