Kelly Frederick, RN, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172246 Issued in VA

Practice address

11842 Rock Landing Dr
Suite 100
Newport News, VA 23606-4437

Phone

(757) 873-0338

Fax

(757) 873-9579

NPI assigned

Jan 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12840/brand/1/csg/1/fhir/r4

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.

• Advanced ENT & Allergy, PC

  • Otolaryngology Physician
  • Newport News, VA
  • NPI 1467816348
  NPD
• Hampton Roads Otolaryngology Associates PLLC

  • Non-Pharmacy Dispensing Site
  • Hampton, VA
  • NPI 1053742031
  NPD (past)

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1841689395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11842 ROCK LANDING DR",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064437",
            "telephone_number": "757-873-0338",
            "fax_number": "757-873-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11842 ROCK LANDING DR",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064437",
            "telephone_number": "757-873-0338",
            "fax_number": "757-873-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "KELLY",
        "credential": "RN, MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Jason Frasca, D.O.
• Rosetta Maria Fratiani, NP
• Charles Owen Frazier, MD
• Leah D Frazier, PT, DPT
• Frederick a. Levy LCSW, LTD.
• Daphney Eddy Frederique, M.D.
• Freedom Choice Home Care LLC
• George Hartley Freeman, M.D.
• Gerald Quinton Freeman Jr., DDS
• Rudolph Freeman Jr., M.D.

• Family Nurse Practitioner in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.