Individual provider Active NPI

Caroline Fredericks, DPT

  • Pediatric Physical Therapist
  • Hendersonville, TN
National Provider Identifier
1831919273
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
16148 Issued in TN
Practice address
139 Maple Row Blvd Ste 300
Hendersonville, TN 37075-4487
Phone
(615) 826-7113
NPI assigned
Oct 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 16148 TN Primary

Addresses

Primary practice location

139 Maple Row Blvd Ste 300
Hendersonville, TN 37075-4487

Mailing address

270 Douglas Bend Rd Apt 1201
Gallatin, TN 37066-5532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241227000490 TN Practitioner - Physical Therapist in Private Practice 5799212064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Center of Hendersonville Pediatrics CurrentSince Nov 4, 2024 Accepting new patients
Wisconsin Orthopedic Physical Therapy Pediatrics PastSince Jun 23, 2024 Accepting new patients

Locations

139 Maple Row Blvd
Ste 300
Hendersonvlle, TN 37075
Phone (615) 826-7113

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1831919273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 DOUGLAS BEND RD APT 1201",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370665532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 MAPLE ROW BLVD STE 300",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370754487",
            "telephone_number": "615-826-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "CAROLINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "16148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.