Individual provider Active NPI

Katherine Fricke, NP

  • Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1801571187
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
114812 Issued in NE
Practice address
6675 Business Pkwy Ste F
Elkridge, MD 21075-6349
Phone
(402) 290-2584
NPI assigned
Jun 15, 2023
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 114812 NE Primary

Addresses

Primary practice location

6675 Business Pkwy Ste F
Elkridge, MD 21075-6349

Mailing address

6675 Business Pkwy Ste F
Elkridge, MD 21075-6349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240122000924 NE Practitioner - Nurse Practitioner 6002268448 Reassigns benefits to 1 organization
I20240203000042 IA Practitioner - Nurse Practitioner 6002268448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

20021 Manderson St
Elkhorn, NE 68022-3233
Phone (402) 815-6600

808 E Pierce St
Methodist Physicians Clinic
Council Bluffs, IA 51503-4652
Phone (712) 396-4360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
114812NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Jan 31, 2024 Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

808 E Pierce St
Council Bluffs, IA 51503
Phone (712) 396-4340

20021 Manderson St
Elkhorn, NE 68022
Phone (402) 815-6600

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

825 S 169th St
Fl S
Omaha, NE 68118

Interoperability endpoints

  • Direct secure messaging: katherine.fricke@direct.nmhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1801571187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 BUSINESS PKWY STE F",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 BUSINESS PKWY STE F",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756349",
            "telephone_number": "402-290-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "KATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "114812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.