Active NPI
Bobbie Frederick, APRN
- Family Nurse Practitioner
- Harlan, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4015323
- 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, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1124253 | KY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Comprehensive Health Corporation | Current | Accepting new patients | |
| Mountain Comprehensive Health Corporation | Current | Accepting new patients | |
| Mountain Comprehensive Health Corporation | Family | Current | Accepting new patients |
| Mountain Comprehensive Health Corporation | Current | Accepting new patients | |
| Mountain Comprehensive Health Corporation | Current | 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
- 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.
-
- Primary Care Clinic/Center
- Whitesburg, KY
- NPI 1417900242
-
dba Mountain Comprehensive Specialty Services
- Pulmonary Disease Physician
- Whitesburg, KY
- NPI 1033166350
-
dba Elkhorn City Optometry Clinic
- Primary Care Clinic/Center
- Elkhorn City, KY
- NPI 1215818414
-
dba Harlan Medical Center
- Primary Care Clinic/Center
- Harlan, KY
- NPI 1316991979
Family
-
dba Knott County Medical Clinic
- Primary Care Clinic/Center
- Hindman, KY
- NPI 1912676511
-
- Primary Care Clinic/Center
- Buckhorn, KY
- NPI 1225082985
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.