Jennifer Fredericks, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME106514 Issued in FL

Practice address

@ Columbia Drive
J402
Tampa, FL 33606

Phone

(813) 844-7412

NPI assigned

Aug 30, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfredericks188912@orlandohealth.medalliesdirect.net

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.

• Emergency Physicians of Crossroads

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1538858774
  Medicare reassignment NPD
• Emergency Physicians of Pinellas PA

  • Emergency Medicine Physician
  • Pinellas Park, FL
  • NPI 1023590056
  Medicare reassignment NPD
• Emergency Physicians of St Petersburg PA

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1851726566
  Medicare reassignment NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1861686123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "@ COLUMBIA DRIVE",
            "address_2": "J402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33606",
            "telephone_number": "813-844-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "@ COLUMBIA DRIVE",
            "address_2": "J402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33606",
            "telephone_number": "813-844-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME106514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "148MZ",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002280100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Navoy Lamont Frederick II
• Patricia Ann Frederick, LCSW
• Alton Fredericks II
• Brittany Fredericks
• Cara Fredericks
• Hunter Vincent Frederique
• Aleyda Gipcell Free, LCSW
• Alan M Freedman, M.D.
• Susan Ruth Freedman
• Freedom Ancillary Health

• Emergency Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.