Individual provider Active NPI

Robert L Frederickson, MD

  • Family Medicine Physician
  • Sedalia, MO
National Provider Identifier
1730146226
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36281 Issued in MO
Practice address
3401 W 10TH St
Sedalia, MO 65301-2112
Phone
(660) 827-2883
Fax
(660) 827-1359
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36281 MO Primary

Addresses

Primary practice location

3401 W 10TH St
Sedalia, MO 65301-2112

Mailing address

21048 Palmer Rd
Sedalia, MO 65301-0583
Phone (660) 827-2883

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100818000417 MO Practitioner - Family Practice 9335220516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

3401 W 10TH St
Bothwell OB GYN Clinic
Sedalia, MO 65301-2112
Phone (660) 827-2883

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth11
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center CurrentSince May 1, 2018 Accepting new patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center Family Medicine CurrentSince May 1, 2018 Accepting new patients
Sylvia G. Thompson Residence Center Past Accepting new patients

Locations

3700 W 10th St
Ste 100
Sedalia, MO 65301
Phone (660) 827-0015

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

3401 W 10th St
Sedalia, MO 65301
Phone (660) 827-2883

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730146226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21048 PALMER RD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653010583",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.