Individual provider Active NPI

Rachel Mary Frederick, AU.D.

  • Audiologist
  • Flower Mound, TX
National Provider Identifier
1710764790
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81591 Issued in TX
Practice address
4491 Long Prairie Rd Ste 400
Flower Mound, TX 75028-2012
Phone
(817) 997-4084
Fax
(817) 333-1190
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 81591 TX Primary

Addresses

Primary practice location

4491 Long Prairie Rd Ste 400
Flower Mound, TX 75028-2012

Mailing address

4491 Long Prairie Rd Ste 400
Flower Mound, TX 75028-2012
Phone (817) 997-4084

Other identifiers 1

IdentifierTypeStateIssuer
81591OtherTXAUDIOLOGY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027002652 TX Practitioner - Qualified Audiologist 0345696282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Hearing Practice PLLCGroup PAC ID 4486954567, 4 clinicians

Practice addresses (Care Compare)

4491 Long Prairie Rd
Suite 400
Flower Mound, TX 75028-1795
Phone (817) 997-4084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81591TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Hearing Practice, PLLC Audiologist CurrentSince Jul 28, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1710764790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4491 LONG PRAIRIE RD STE 400",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282012",
            "telephone_number": "817-997-4084",
            "fax_number": "817-333-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 LONG PRAIRIE RD STE 400",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282012",
            "telephone_number": "817-997-4084",
            "fax_number": "817-333-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "RACHEL",
        "middle_name": "MARY",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "81591",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.