Individual provider Active NPI

Bobbie Frederick, APRN

  • Family Nurse Practitioner
  • Harlan, KY
National Provider Identifier
1841958709
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4015323 Issued in KY
Practice address
132 Village Center Rd
Harlan, KY 40831-1777
Phone
(606) 573-7771
Fax
(606) 573-2809
NPI assigned
Dec 7, 2021
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4015323 KY Primary
Registered Nurse 163W00000X 1124253 KY

Addresses

Primary practice location

132 Village Center Rd
Harlan, KY 40831-1777

Mailing address

282 Highway 2425
Harlan, KY 40831-7063
Phone (859) 618-5520

Other practice location 1

60 Phillips Branch Rd
Phelps, KY 41553-9061
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240606000453 KY Practitioner - Nurse Practitioner 7517409550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

132 Village Ctr Rd
Harlan, KY 40831-1777
Phone (606) 573-7771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1124253KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Health Corporation Current Accepting new patients
Mountain Comprehensive Health Corporation CurrentSince Jul 15, 2025 Accepting new patients
Mountain Comprehensive Health Corporation Family Current Accepting new patients
Mountain Comprehensive Health Corporation Current Accepting new patients
Mountain Comprehensive Health Corporation CurrentSince Jul 15, 2025 Accepting new patients
Mountain Comprehensive Health Corporation Past Accepting new patients

Locations

132 Village Center Rd
Harlan, KY 40831
Phone (606) 573-2004

226 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871

Interoperability endpoints

  • Direct secure messaging: bobbie.frederickaprn.p1@direct.mtncomp.nextgenshare.com

Organizations & group practices 6

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1841958709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 HIGHWAY 2425",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408317063",
            "telephone_number": "859-618-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 VILLAGE CENTER RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311777",
            "telephone_number": "606-573-7771",
            "fax_number": "606-573-2809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Phillips Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Phelps",
            "state": "KY",
            "postal_code": "415539061",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "BOBBIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4015323",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1124253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

Verify at the official NPI Registry.